Managing your pain is an important part of your breast cancer treatment at Holland Hospital. Some women experience pain resulting from the cancer itself and/or from the cancer treatments. Talk to your doctor if pain becomes a problem for you. The amount of pain you experience may depend on the extent of your breast cancer and your personal tolerance for discomfort.

Pain during cancer and cancer treatment can have a number of causes, including tumors, surgery, chemotherapy, radiation therapy, certain medications, cancer in the bone, and other conditions.

Philosophy of Care
When it comes to managing your pain, as with all other aspects of your cancer care, communication is vital. Doctors won't know how much pain you are experiencing unless you tell them. It's also important to tell your doctors which treatments are working for you and which are not. With your help, we will determine what is causing your pain and the best way to treat it. We can be most effective in helping you when you are an informed and active participant in your treatment.

Protocol
Pain Management in the early stages - Often in the early stages of cancer and cancer treatment, nonsteroidal anti-inflammatory drugs such as ibuprofen or acetaminophen can provide adequate relief for mild to moderate pain. If this is not the case for you, talk to your doctor about switching to a more powerful opioid pain reliever such as oxycodone or morphine.

During chemotherapy, you may experience pain in your bones, muscles or joints. Ibuprofen, acetaminophen, opioids, anti seizure medications and antidepressants can often relieve this kind of pain. Although these medicines may make people drowsy and constipated, resting and taking laxatives can help. While many people worry that they will become addicted to pain medicine, these drug dependencies are rare develop when medication is properly prescribed.

Pain Management in the later stage: As cancer spreads, pain may develop as tumors pressure bones, nerves or organs.

• Bone pain - Pain in the bones may be reduced with medications such as steroids or radiation therapy. External beam radiation therapy provides substantial long-lasting pain relief in more than 85% of people by shrinking tumors that have metastasized (spread). If bone pain is widespread, treatment can include prescription anti-inflammatory drugs and opioids. Intravenous drugs that strengthen bones, decrease pain and help prevent fractures also benefit women with widespread bone pain.
• Nerve pain and headaches - Nerve pain and headaches are caused by cancer which has grown around, along and into nerves, the brain or the spinal cord. This pain may respond best to a combination of therapies. First, you may be given steroids to relieve some of the swelling and pressure on the nerve tissue and antidepressants or antiepileptics to help control burning and tingling. Then you may receive radiation therapy to shrink the cancer where it presses on the nerves.
• Arm or leg pain - Spread of cancer to the lymph nodes may cause arm or leg pain. Pain that occurs after mastectomy and doesn't go away may be relieved by a procedure in which lymph nodes from the thigh are transplanted into the underarm area.
• Whole-body pain - When tumors have spread and cause pain throughout the body, more aggressive pain management is needed. This whole-body pain is often treated by medication delivered through a needle drip (a pump inserted under the skin) or a skin patch.