Managing Pain from Treatment

Advanced breast cancer can cause pain, and 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, may be a short-term or a long-term side effect. Pain may be acute, persistent, or breakthrough. Acute pain is a sudden, brief and intense type of pain, while 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 medication and 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 psychological health of the patient prior to surgery is related to the potential for persistent pain after surgery. Women who have depression, anxiety, or poor sleep quality may be at greater risk of experiencing persistent pain after breast cancer surgery.3,4

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

Pain from chemotherapy

Chemotherapy is frequently used to treat advanced breast cancer and can cause a range of side effects, including nausea, vomiting, hair loss, and pain. The pain caused by some chemotherapy medications can be due to damage of the nerves in the extremities (hands and feet) by the medications, called peripheral neuropathy. Neuropathic pain may feel like numbness, burning, tingling, pain, or sensitivity to cold or heat in the hands or feet. For some people, these sensations go away when chemotherapy is completed, but 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 medication to lessen the sensations. In addition, many people find complementary approaches like acupuncture to be beneficial. Physical therapy may also help. Patients should discuss options for treating their pain with their healthcare professional.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 of metastasis, where cancer has spread, such as in cases where breast cancer has spread to the bones.8 Wherever the radiation is directed, the skin in that area can potentially become sore and painful.

Pain from hormone therapy

One of the most common side effects from hormone therapy is hot flashes, but hormone therapy may also cause pain in the joints or muscles.9,10

Pain from targeted therapy

Possible side effects from targeted therapy are specific to the type of targeted therapy. Each medication has its own potential side effects. Some targeted therapies can cause joint or muscle pain, in addition to other side effects.11

Emily Downward | Last reviewed: December 2018.
View References
  1. Pain. BreastCancer.org. Available at https://www.breastcancer.org/treatment/side_effects/pain. Accessed 8/10/18.
  2. Surgery for breast cancer. Cancer Treatment Centers of America. https://www.cancercenter.com/breast-cancer/surgery/. Accessed 8/10/18.
  3. Mejdahl MK, Mertz BG, Bidstrup PE, Andersen KG. Preoperative distress predicts persistent pain after breast cancer surgery: a cohort study. J Natl Compr Canc Netw. 2015 Aug;13(8):995-1003. Abstract.
  4. Schreiber KL, Kehlet H, Belfer I, Edwards RR. Predicting, preventing and managing persistent pain after breast cancer surgery: the importance of psychosocial factors. Pain Manag. 2014;4(6):445-59. doi: 10.2217/pmt.14.33. Abstract.
  5. Chemotherapy for breast cancer. Mayo Clinic. Available at https://www.mayoclinic.org/tests-procedures/chemotherapy-for-breast-cancer/about/pac-20384931. Accessed 8/10/18.
  6. Managing chemotherapy-induced peripheral neuropathy after cancer treatment. Memorial Sloan Kettering Cancer Center. Available at https://www.mskcc.org/blog/managing-chemotherapy-induced-peripheral-neuropathy-after-treatment. Accessed 8/10/18.
  7. Radiation therapy. National Breast Cancer Foundation. Available at https://www.nationalbreastcancer.org/breast-cancer-radiation-therapy. Accessed 8/10/18.
  8. Treating bone metastases. American Cancer Society. Available at https://www.cancer.org/treatment/understanding-your-diagnosis/advanced-cancer/treating-bone-metastases.html. Accessed 8/10/18.
  9. Cancer pain. National Cancer Institute. Available at https://www.cancer.gov/about-cancer/treatment/side-effects/pain/pain-pdq. Accessed 8/10/18.
  10. Hormone therapy for breast cancer. National Cancer Institute. Available at https://www.cancer.gov/types/breast/breast-hormone-therapy-fact-sheet#q6. Accessed 8/10/18.
  11. Targeted therapy for breast cancer. American Cancer Society. Available at https://www.cancer.org/cancer/breast-cancer/treatment/targeted-therapy-for-breast-cancer.html. Accessed 8/10/18.