Pain and Symptom Management: Talk to Your Health Care Team

It is important to maintain open and honest communication with your health care team about any symptoms or pain that you are experiencing to help improve your quality of life. For people living with cancer, managing pain and other symptoms often depends on whether the cancer has spread to other parts of the body and the location of the tumors.

Origins of Pain

• Directly from the tumor: depending on its location and size, the tumor can be a source of discomfort
• Treatment-related: due to side effects of chemotherapy or radiation
• Post-operative: result of a surgical procedure

Remember that it can be helpful to bring a family member or friend when visiting the physician. Whether in person or by application or telephone, having someone with you can be an added support during a difficult time. They can help by taking notes and asking questions pertaining to your diagnosis and treatment.

Talking to Your Doctor About Pain

These are some of the things to discuss with your health care team and some of the questions they may ask you:

When and where is your pain? You may experience pain in more than one place in your body. Providing your doctor specifics about the pain can help them understand the cause of pain in each place. Was there a particular event that led to the pain? When did it start? Did it begin spontaneously? Does the pain move from one area to another?

What does the pain feel like? For example, is it dull, sharp, burning, pinching or stabbing?

What Kind of Pain is it?

• Acute pain: usually doesn’t last a long time and can range in intensity
• Chronic pain: can last more than a couple of days and range in intensity
• Breakthrough pain: occurs suddenly and may happen when doing certain movements or performing a certain activity

What is the intensity of your pain? Is it mild, moderate or severe? There are different pain scales can help you rate your pain:

• The simplest scale goes from 0 to 10, with 0 equaling no pain and 10 equaling the worst pain possible.
• A verbal scale uses mild, moderate and severe as key words to describe pain levels.
• A series of cartoon-like faces shows differing degrees of discomfort from 0 to 10.

Does anything make the pain worse? For example, does standing or sitting make it hurt more? Is it worse at night and better during the day? Does a change in temperature intensify or relieve the pain? Do you feel more pain on a cold day?

Does anything relieve the pain? Do you feel better if you massage the area or if you lie down/walk around?

How much relief are you getting from pain medication? Does your pain medication provide you with enough relief? Does it wear off before it’s time for your next dose? Are you having any side effects?

Are you having any breakthrough pain? How many episodes of breakthrough pain do you have? When do they occur? How long do they last? What makes them better?

Is the pain affecting your everyday life? Is pain disturbing your sleep or your ability to eat? Is it impacting your ability to complete activities of daily living? Are you able to go about your day without being interrupted by pain?

A Pain and Symptom Journal

Writing down any symptoms or side effects that you experience on a daily basis can help inform you and your health care team about how to improve your care. As a result of keeping a treatment journal, you may notice patterns in the onset of pain and symptoms that you didn’t notice before. Writing in a journal can also help you feel empowered as you cope with cancer.

Work with your health care team to make a list of all of your medications, chemotherapy and targeted treatments, including their dosage and the frequency in which they are taken. To keep track of side effects, you may find it helpful to write down information such as:

• When the side effect occurred and for how long
• How strong the discomfort/pain was on a scale of 1-10
• How the side effect impacts your daily activities
• Contact information for each member of your health care team
• When to call your doctor and/or go to the emergency room with a symptom
• Questions or concerns you have

Edited by Danielle Saff, LMSW