Pain and Advanced Breast Cancer Treatment

Advanced breast cancer can cause pain. Many of the treatment options for advanced breast cancer may also cause pain as a side effect. Like other side effects from breast cancer treatment, pain may be a short-term or a long-term side effect.¹

Pain may be acute, persistent, or breakthrough. Acute pain is a sudden, brief and intense type of pain. Persistent pain lasts for a longer time and can range from mild to severe. Breakthrough pain is a type of pain that “breaks through” pain medicines. It is described as a sudden worsening of persistent pain.¹

Pain has a major impact on a person’s quality of life. There are ways to manage, lessen, or relieve pain from cancer or its treatments.

Pain from surgery

Surgery can cause short-term pain and soreness. After surgery, the treated area, which may include the breast and underarm, can feel tight and swollen. One possible complication from surgery to the lymph nodes under the arm (axillary lymph nodes) is lymphedema, a swelling in the arm. Lymphedema may also cause pain and discomfort.²

Most pain from surgery is temporary and eases with time as the body heals. But some people may have persistent pain after breast cancer surgery. Some studies have suggested that the emotional or mental health of a person before surgery is related to the potential for persistent pain after surgery. Those who have depression, anxiety, or poor sleep quality may be at greater risk for persistent pain after breast cancer surgery.^3,4

Pain from surgery, whether acute or persistent, can be managed with medicines and complementary approaches.

Pain from chemotherapy

Chemotherapy is often used to treat advanced breast cancer. It can cause a range of side effects, including:⁵

• Nausea
• Vomiting
• Hair loss
• Pain

Some chemotherapy drugs can damage the nerves in the hands and feet, causing pain. This is called peripheral neuropathy. Neuropathic pain may feel like:⁵

• Numbness
• Burning
• Tingling
• Sensitivity to cold or heat in the hands or feet

For some people, these sensations go away when chemotherapy is completed. Others may continue to have neuropathy long-term.⁵

Not everyone who receives chemotherapy for advanced breast cancer experiences peripheral neuropathy. Certain chemotherapy drugs are more likely to cause this side effect than others.⁶

Neuropathic pain can be treated with drugs to lessen the sensations. Many people also find complementary approaches like acupuncture to be helpful. Physical therapy may also help. Discuss options for treating pain with your doctor.⁶

Pain from radiation

Radiation may cause pain to the skin of the targeted area. If radiation is given to the breast or underarm area, the skin there may become red, irritated, and tender.⁷

Radiation may also be given to areas where cancer has spread, like in cases where breast cancer has spread to the bones. Wherever the radiation is directed, the skin in that area may become sore and painful.⁸

Pain from hormone therapy

One of the most common side effects of hormone therapy is hot flashes. However, hormone therapy may also cause joint or muscle pain.^9,10

Pain from targeted therapy

Side effects from targeted therapy are specific to the type of targeted therapy. Each medicine has its own possible side effects. Some targeted therapies can cause joint or muscle pain, along with other side effects.¹¹