Pain and early breast cancer or DCIS treatment

Many people experience pain or discomfort at some point during treatment for early breast cancer or DCIS. For some, this is for a short period. For others, pain or discomfort can last for weeks – or even years – after treatment.

There are many options to help you manage pain. Don't be afraid to ask for help. 

Discuss any pain with your GP, specialist or breast care nurse so they can help you manage it effectively.

Causes of pain

Short-term pain

Short-term (‘acute’) pain is pain that doesn’t usually last longer than 3 to 6 months.

Common causes of acute pain for people dealing with breast cancer include:

• pain after breast surgery such as lumpectomy, mastectomy or breast reconstruction
• pain and discomfort as a side effect of radiotherapy
• as a side effect of chemotherapy such as mouth ulcers, muscle or joint pain.

Long-term pain

Pain that lasts longer than 6 months is long-term (‘chronic’) pain. This can have a major effect on your life. Chronic pain can lead to anxiety, depression, a lack of energy and reduced social activities.

There are many possible causes of chronic pain for people dealing with breast cancer.

Common causes include:

• ongoing discomfort after surgery due to scars or nerve damage
• nerve pain from some chemotherapy treatments
• joint and muscle pain from hormone-blocking therapy
• pain after you finish treatment.

How to describe your pain 

It can be hard to describe your pain to your treating team or to other people.

The more accurately you can describe the pain, the easier it is for doctors to prescribe effective treatment. Different types of pain are managed in different ways.

It may be helpful to keep a diary to record the following:

• If 0 is no pain at all and 10 is the worst pain you could imagine, what number is yours?
• What does the pain feel like: a dull ache or more like stabbing or burning?
• Is it constant or does it come and go (intermittent)?
• If it comes and goes, when is it at its worst and how long does it last?
• Is it easy to pinpoint where the pain is or is it more general?
• Does anything provide relief or make it worse?
• If you have tried medications, did any work better than others?

Assessment for pain

It is important your treating team assesses you fully for any pain or discomfort. They can make sure you can receive the most effective and appropriate treatment.

During the assessment, they will ask about:

• any unrelated medical conditions you have that can cause pain or discomfort, such as arthritis or a previous injury
• the pain itself, including:
• the type of pain (dull/sharp/shooting)
• site of pain
• whether the pain is constant or comes and goes.
• what pain medication you have been taking and whether it is helping.
• any activity or movement that makes your pain worse.
• any other therapies, such as acupuncture, you may be using to help manage the pain.

Ways to manage pain

Once your team completes the assessment, they can develop a plan to manage your pain.

This is an agreed outcome of discussions between you and your treating team. Pain management plans include a holistic approach to ensure that the plan addresses your physical, emotional and social needs.

Your pain management plan may include:

• medication such as painkillers (‘analgesics’)
• physiotherapy to treat the parts of your body that hurt
• an exercise plan
• complementary therapies such as acupuncture, massage, meditation and yoga
• strategies to maintain a healthy weight, to relieve additional stress on your joints and muscles
• a well-balanced diet, to help with body tissue repair and physical wellbeing
• tips to help you sleep well
• seeing a psychologist or counsellor if chronic pain is causing anxiety or emotional distress.

It is important to regularly review your pain management plan with your treating team. They may make changes if it is not working effectively.

Always discuss with your treating team first any other strategies such as complementary or alternative therapies that you may be considering using, to make sure they are safe. Some therapies can interact with your treatments.