Managing pain due to breast cancer

What is breast cancer?

Breast cancer is the most common type of cancer in women. Malignant (cancerous) tumors are most often found in the ducts (tubes that carry milk to the nipple) and sometimes in the lobules (glands that produce milk).When cancer spreads outside of a duct or gland to other breast tissue, it’s called invasive breast cancer. Inflammatory breast cancer is a rare form of the disease that causes redness on the skin and swelling of the breast.

What are the signs and symptoms of breast cancer?

When breast cancer first starts, there may be no symptoms. This why it’s so important to have regular mammograms as recommended by your doctor. As the cancer grows, though, a lump or mass is sometimes found in the breast or armpit. Later, there may be swelling in the armpit, changes in the look of the breast or nipple, or even an unusual leakage of fluid from the nipple. When breast cancer spreads beyond the breast itself, it can grow in lymph nodes, or in other areas like the bones, lungs, liver, or skin.

How breast cancer is treated

Since different kinds of cancer are treated in different ways, the treatment that’s chosen depends on the stage of the cancer (how advanced it is) and the type of cancer cell that’s involved. (See the article on Understanding Cancer Stages.)

Surgery
There are two main types of surgery for breast cancer:

  1. A lumpectomy removes only the tumor and, sometimes, nearby lymph nodes – not the whole breast.
  2. A mastectomy removes part – or all – of the breast, along with some of the surrounding tissue; lymph nodes may also be removed. Many women choose to have breast reconstruction surgery afterwards, to recreate as much of a natural-looking breast as possible by a plastic surgeon.

Chemotherapy
Chemotherapy is when cancer-fighting drugs are given by pill, or injected directly into the bloodstream. The goal of chemotherapy is to destroy cancer cells in the wherever they may exist in the body.

Radiation therapy
Radiation – or a radioactive substance in a small capsule or container – is directed directly at the site of the tumor to kill or shrink cancer cells, or to keep them from growing.

Hormone therapy
This treatment removes or blocks hormones, such as estrogen, that helps some types of breast cancers grow.

Biologic therapy
Biologic therapy uses the body’s immune system to fight cancer, by blocking the chemical signals that tumors need to grow. It can also help cut down on the side effects caused by some cancer treatments.

Breast cancer pain

Managing pain from breast cancer

Most breast cancers don’t cause pain at first. However, it’s possible for pain to occur anytime from diagnosis until treatment, and it may last for a while.

Some cancerous lumps may feel prickly, tender, or painful. When a tumor presses on bones, nerves, or organs, it may also cause pain. This pain can be treated with medication, even before starting treatment with chemotherapy, surgery, and/or radiation.

Breast cancer can cause pain in other parts of the body if it metastasizes (spreads) to those areas. The most common site of metastatic breast cancer is the bones; other sites include the liver, lungs, brain, and spinal cord.

Metastatic breast cancer in the bone can cause a deep, aching pain, usually from the bone breaking down. When breast cancer spreads to the spinal cord, it can cause pain in the back, legs, or neck. It is usually treated by surgery and/or radiation and steroids.

Managing pain from breast cancer treatment

During a mastectomy, lymph nodes in the underarm may be removed and looked at closely to see if the cancer has spread (lymph node involvement). If cancer is found, treatment may include surgery to remove some or all of the lymph nodes, along with radiation to the area. Depending on the extent of the surgery, there may be pain and swelling in the arm or hand, causing a condition known as lymphedema. If needed, a special, stretchy sleeve that squeezes the arm and helps to drain the fluid can be worn.

Surgery, radiation therapy, and some kinds of chemotherapy may also cause neuropathic (nerve) pain. Neuropathic pain can be felt as tingling, burning, shooting, or stabbing types of pain, along with numbness; it may successfully be treated with many different medications.

When you experience pain

Your comfort is an important part of cancer treatment. With so many medications and ways to handle cancer pain, no patient should have to live with pain that goes untreated. If you’re uncomfortable in any way, don’t hesitate to tell your doctor or nurse. Start a journal that keeps track of your pain: when it starts, where it’s located, how long it lasts, how bad it is, what makes it better or worse, what you’ve done to try to deal with it, and whether your pain management plan is working to relieve the pain.

References

National Cancer Institute. (2008). Breast cancer treatment option overview. Retrieved 7/1/08 from www.cancer.gov.

National Cancer Institute. (2008). What you should know about treating cancer pain. Retrieved 7/1/08 from www.cancer.gov.

National Cancer Institute. (2006). Biological Therapies for Cancer: Questions and answers.Retrieved 10/1/08 from www.cancer.gov.