How Lung Cancer Pain Is Treated

Pain is very common with lung cancer and can be quite profound, but you can get relief. Your pain management should be tailored to the exact source of your discomfort and may include a combination of medication and procedures. Getting control of your pain will improve your quality of life and ability to cope as you go through cancer treatment or are receiving palliative care. The first step: Being upfront with your medical team about how you are feeling.

Home Remedies and Lifestyle

Lung cancer-associated pain may require medical intervention, but there are also some things you can do on your own to reduce your pain. These approaches may help minimize the amount of medication you need to use and decrease the overall burden of your pain.

Strategies you can incorporate into your life include:

• Getting enough rest: Being tired can increase your perception of pain and reduce your pain tolerance. Make sure you are well rested to feel your best.
• Dressing comfortably: Ill-fitting clothes or shoes or scratchy materials can add to unpleasant sensations due to complications like neuropathy due to chemotherapy.
• Paying attention to your furniture: With lung cancer, chest aches or bone pain can hurt tremendously. Make sure your seating and your bed aren't placing extra pain-inducing pressure or adding to your discomfort in any way.
• Using an ice pack: If you have soreness due to edema (fluid accumulation), an ice pack can help bring down the swelling.

These strategies can be helpful, but know that it's highly unlikely that simple at-home approaches alone will be enough to ease your discomfort, particularly if you have advanced lung cancer and are receiving palliative care to ease severe symptoms.

Over-the-Counter (OTC) Therapies

Often, pain due to lung cancer can be alleviated with OTC therapies. However, you should talk to your healthcare provider before taking any medications because even non-prescription options can cause side effects that may be dangerous if you have lung cancer.

OTC pain medications your healthcare provider might recommend for you include:

• Non-steroidal anti-inflammatories (NSAIDs): Commonly used NSAIDs include Aleve (naproxen) and Advil (ibuprofen). These medications can relieve pain and fevers, typically without severe side effects. Studies suggest they may be associated with better long-term lung cancer survival. In people with advanced stage 3 and stage 4 disease, NSAIDs are considered the first-line option for pain control. However, NSAIDs can cause stomach upset and increase your risk of bleeding, especially if you are already predisposed to it.
• Tylenol (acetaminophen): This mild pain reliever can offer relief, but it's not safe if you have liver disease—including liver metastasis from lung cancer.
• Aspirin: Aspirin is a popular pain reliever that's also a blood thinner. Your healthcare provider might recommend it if you also need to be taking a blood thinner for stroke prevention, but it can cause bleeding if you're at risk of this side effect.
• Transdermal patches, such as Salonpas: These deliver analgesics directly through the skin. They are generally safe but can cause skin irritation and, in some cases, systemic side effects.
• Capsaicin cream: This cream can be placed on the skin to help relieve pain. It might not have an effect on deep pain, but you might experience relief of some types of neuropathic pain.

Some OTC medications are also available in prescription-strength formulations. You and your healthcare provider might decide that's the route for you if you experience only partial relief from these medications without substantial side effects.

Prescriptions

When it comes to prescription medications, some types of pain tend to respond better to certain treatments. Your pain management will be tailored to the cause of your pain. There are a number of options.

Pain Killers

Pain due to metastasis or incisional pain after surgery may improve with strong opioid painkillers. Vicodin and Percocet are examples of such medications.

Opioid medications can cause severe drowsiness, which may interfere with your quality of life. They are also potentially addictive, so they're meant to be used as a treatment for severe pain only when a short duration of use is anticipated. Long-term use of opioids can actually lead to hyperalgesia (increased pain). In high doses, opioids can also cause respiratory depression.

Generally speaking, healthcare providers will start by prescribing a weak opioid like hydrocodone, often with a non-opioid painkiller. If this doesn't provide relief, particularly in people with advanced disease and severe intractable pain, a stronger opioid like morphine or fentanyl may be prescribed.

Neuropathic pain can feel like constant or intermittent burning or tingling. And chronic post-surgical pain can persist long after an incision has healed. These types of pain might not improve with OTC pain medications or opioids. Rather, chronic pain associated with lung cancer is often treated with tricyclic anti-depressants like Pamelor (nortriptyline), anti-seizure medications like Neurontin (gabapentin), or steroids like dexamethasone.

Additionally, some aspects of lung cancer discomfort, such as muscle stiffness or nausea, may improve with medical marijuana. Antidepressants and anti-anxiety medications are also sometimes used to relieve emotional distress that can complicate acute or chronic cancer pain.

Management of Complications

Chest pain due to a chronic cough or breathing difficulties associated with lung cancer might require an approach that involves treatment of the pulmonary problems, such as with bronchodilators.

Severe edema can cause pain in areas that are swollen, and the swelling is treated with oral or intravenous (IV) corticosteroid treatment.

Mouth sores, which can develop due to chemotherapy, are managed with a diet that includes soft foods that aren't too acidic or spicy. Your dentist may also prescribe an ointment to help soothe sores. A rinse called magic mouthwash, with a mix of ingredients, often helps.

Surgeries and Specialist-Driven Procedures

Interventional pain control techniques include procedures that are directed to the anatomical location of the pain. They generally don't have systemic side effects, but they also only treat pain that's specifically targeted by the procedure (rather than diffuse pain throughout the body).

Some of these methods include:

• Nerve block: With this procedure, pain medication is injected around a nerve or into the spine fluid (intrathecal delivery) to reduce the pain sensation mediated by the nerve. This is a temporary effect that may wear off after a few months. Intrathecal pumps also are used.
• Neurolytic block: With neurolysis, a provider destroys the nerve tissue in the pain pathway by injection (typically ethyl alcohol, phenol, or glycerol) into a nerve or the spinal fluid. This technique has a long-lasting or permanent effect.
• Epidural block: Anesthesia delivered via epidural block can be used to manage lung cancer pain after surgery, in combination with general anesthesia, but also may offer anti-inflammatory benefits and limit cognitive impacts.
• Spinal cord stimulation: This procedure involves the implantation of a device that produces vibrations to reduce the sensation of pain. The device can be controlled with an external stimulator, and it can be removed in another procedure if necessary.
• Neurosurgery: Removal of metastatic tissue can alleviate pain caused by spinal metastases. And when pain is persistent and severe, transecting the nerve that mediates pain signals can alleviate the sensation. This can result in permanent loss of sensation, however.
• Radiation: This treatment (and/or surgery, chemotherapy, immunotherapy, or a combination) can reduce the size of a tumor that's in the lungs or the size of metastatic lesions, which can substantially reduce pain in some circumstances. Radiation therapy is often used to reduce pain in people with cancer near the end of life. Lung cancer is the most common reason for this use, followed by breast cancer and prostate cancer.

Complementary and Alternative Medicine (CAM)

Stress, depression, and anxiety can amplify the perception of pain in people with cancer, particularly those with advanced disease.

While antidepressants may be prescribed in severe cases, some complementary and alternative therapies may help as well. These are not substitutes for medical or interventional pain treatments, but they might help reduce your need for such therapies.

• Counseling: Cognitive behavioral therapy (CBT) is a form of counseling that aims to reframe pain-related thoughts from negative ones (e.g., "I can't stand this") to positives ones (e.g., "I can do this").
• Mind-body therapies: Alternative practices like yoga, progressive muscle relaxation, guided imagery, and tai chi not only provide physiologic benefits but cause "sensory competition" in the brain, essentially distracting you from perceptions of pain.
• Physical therapy: Although not considered a CAM per se, physical therapy appears effective in reducing acute and chronic pain associated with cancer by improving strength and range of motion in people whose posture and restriction of mobility may be aggravating pain. Physical therapists can also teach clients how to modify activities, conserve energy, simplify work practices, and use assistive devices to reduce pain.
• Acupuncture: The benefits of acupuncture in the management of cancer pain is uncertain. With that said, many people turn to it for relief and there is evidence, albeit weak, that it can provide durable pain control and improve mood in some people with cancer.
• Massage: Therapeutic massage is another modality that may provide pain relief in some but not others. When used as a means of relaxation, it can be extremely beneficial in relieving emotional distress that can complicate pain. The direct physiologic impact of massage on cancer pain is less certain, with some studies showing benefits and others not.

A Word From Verywell

Pain can have a major effect on your quality of life. As you are managing your lung cancer treatment and recovery, don't hesitate to express your feelings about your pain to your medical team. If you have concerns about medication side effects or the potential for addiction, discuss these issues with your healthcare provider so you can use a treatment approach that you feel comfortable with. It's also important that you give your healthcare providers feedback about your treatment so it can be adjusted, if necessary.