There are many different types of painkillers. They vary both in their strength and in the way they work. Some painkillers are better for certain types of pain, and some suit certain men better than others. It’s often better to take painkillers regularly, even if you’re not in pain when the next dose is due. This is because painkillers not only relieve pain at the time, but prevent it from coming back too.
Painkillers can be taken as tablets, liquids, or as suppositories that are inserted into the back passage. Some are also given as injections under the skin or patches that are applied to the skin.
It’s important to tell your doctor or nurse if the painkillers you’re taking aren’t easing your pain. Your doctor can either change the dose or change the painkillers to something else that will be more effective for you.
Pain caused by prostate cancer cells in a bone can be severe. Radiotherapy is very good at easing this type of pain, but can take a few weeks to work. Often drugs containing morphine are needed while the treatment is being planned, or while you are waiting for the radiotherapy to work.
Some men find that morphine makes them feel drowsy when they first start taking it, but this usually only lasts for a day or so. Taking morphine may also make some men feel sick at first, and they may need to take an anti-sickness (anti-emetic) tablet prescribed by their doctor for the first few doses. It may also cause constipation.
A number of other drugs can help to relieve pain. If pain is due to prostate cancer cells in a bone, non-steroidal anti-inflammatory drugs (NSAIDs) can help. These have few side effects, but can sometimes irritate the lining of the stomach.
Drugs called bisphosphonates can also help relieve bone pain. Bisphosphonates such as Zoledronic Acid (Zometa®) can help to strengthen bones and lower the risk of fractures. They can also reduce high levels of calcium in the blood (hypercalcaemia), as well as reduce pain. They may be given into a vein (intravenously) in the outpatients department every 3-4 weeks.
Denosumab is a new drug that helps to protect the bones, but it works in a different way to bisphosphonates. It may not be widely available - your doctor can give you more information.
If you’re having trouble sleeping because of pain, your doctor can prescribe sleeping tablets or a mild relaxant.
Anxiety and lack of sleep can make pain worse. For this reason, some men also find that practising relaxation techniques helps them feel more comfortable. A gentle massage can also help your body relax and distract your mind from pain. It’s advisable to have a massage from a trained massage therapist who works with cancer patients.
Heat can also help to ease pain. A long soak in a warm bath, a heat pack or a well-protected hot water bottle can all bring some short-term pain relief for some men.
Being in pain can make you feel very low. It’s important to let your doctor know if the drugs prescribed aren’t working. Remember there are many different ways to control pain. There are special NHS pain clinics run by doctors and nurses who are experts in treating pain. You can ask your doctor to refer you to a clinic if your pain is not controlled by any of the methods mentioned here.
We have more information in our section on controlling cancer pain, and our section on called the symptoms of cancer, which you may find helpful.