Manage Physical Pain
What causes physical pain in cancer patients?
Pain is one of the most common symptoms in cancer patients. Pain can be caused by cancer, cancer treatment, or a combination of factors. Tumors, surgery, intravenous chemotherapy, radiation therapy, targeted therapy, supportive care therapies such as bisphosphonates, and diagnostic procedures may cause you pain – National Cancer Institute
It takes everything out of me—the pain is relentless.” “It’s hard to focus and think—it’s like there’s a curtain in front of the world.
Patient
Physical Pain:
- frequently reported and among the most distressing symptoms for patients.
- experienced by approximately 59–77% of patients during treatment
- ranges from mild aches to severe and debilitating discomfort.
- includes general, localized, or nerve-related pain, which significantly impairs daily functioning and quality of life.
- remains common even after active therapy.
- medication can help but might come with side effects.
- increases symptom distress and worsens fatigue severity. Studies show that pain and depression are among the strongest predictors of fatigue intensity. Pain’s interference with routine tasks and sleep further deepens fatigue and distress. For example, patients with higher levels of depression and pain tend to report more severe cancer-related fatigue.
Note: Stress worsens fatigue and pain in cancer patients by promoting and amplifying inflammation through neuroendocrine-immune interactions, increasing pro-inflammatory cytokines that induce fatigue-related sickness behaviors and intensify pain perception. Managing psychological stress may therefore be crucial to reducing inflammation and the physical symptom burden in cancer patients. Manage Anxiety and Stress
Other physical symptoms frequently reported by cancer patients in reviews and large surveys are:
- Fatigue
- Sleep Disturbance
- Neuropathy
- Loss of appetite and weight loss
- Memory Loss (“chemo brain”) and Cognitive Problems
- Shortness of breath (dyspnea)
- Nausea and vomiting
- Sore mouth
- Swelling in extremities (Edema)
Pain is a daily battle, and it’s exhausting both physically and mentally.
Patient
Therapies that can help control cancer-related pain and other physical symptoms.
Physical Pain
Cannabis
According to the National Cancer Institute, when cancer pain is severe and persistent, it is often resistant to treatment with opioids. A double-blind, placebo-controlled study reported that 15 mg and 20 mg doses of THC were associated with substantial analgesic effects, with antiemetic effects and appetite stimulation.
Study: Nausea, appetite loss, pain, and anxiety are all afflictions of wasting, and all can be mitigated by marijuana.
In this 2023 study findings from a 1500+ patient survey found that cancer survivors with High Impact Chronic Pain have a higher prevalence of cannabis use compared to those patients without pain.
This study found: Cannabis is useful in combatting anorexia, chemotherapy-induced nausea and vomiting, pain, insomnia, and depression. Cannabis might be less potent than other available antiemetics, but for some patients, it is the only agent that works, and it is the only antiemetic that also increases appetite.
This 2023 study found: two weeks of ad libitum cannabis use was associated with improvements in pain intensity and interference, sleep quality and subjective cognitive functioning. It is particularly of note that high CBD, not THC, use during this two-week period was associated with steeper improvements in pain intensity and sleep quality.
Virtual Reality
This 2024 study involving a total of 128 adult hospitalized patients with cancer concluded: Among hospitalized adult patients with moderate-severe pain related to cancer and cancer therapies, VR provided more nonpharmacologic pain relief than active control and this benefit sustained long after conclusion of the intervention.
Low dose Naltrexone
Evidence suggests that naltrexone, when used in low dose (1.75-4.5mg), shows inhibitory properties at the opioid receptors enabling the body to increase the production of endogenous opioids (endorphins) along with upregulating the immune system, according to this Study.
Methadone
This 2017 study says: Methadone has beneficial characteristics as an analgesic against cancer pain, including high bioavailability, multiple receptor affinities, and lack of active metabolites that might induce adverse side effects.
Asaigermanium
Asaigermanium has been shown to have an analgesic effect to reduce “painfulness” in basic and clinical trials…it is also known that Asaigermanium does not have side effects such as clouding of consciousness, dependence and constipation like seen in morphine, a narcotic analgesic.
Acupuncture
This study says: Recent advances in acupuncture clinical research suggest that acupuncture may provide clinical benefit for cancer patients with treatment-related side effects such as nausea and vomiting, post operative pain, cancer related pain, chemotherapy-induced leukopenia, postchemotherapy fatigue, xerostomia, and possibly insomnia, anxiety and quality of life
Biofeedback
Biofeedback is a technique you can use to learn to control your body’s functions, such as your heart rate. With biofeedback, you’re connected to electrical sensors that help you receive information (feedback) about your body (bio). This feedback helps you focus on making subtle changes in your body, such as relaxing certain muscles, to achieve the results you want, such as reducing pain.
Biomagnetic Pair Therapy
Biomagnetic Pair Therapy can help reduce pain. This reduction in pain can lead to an improved quality of life
Chiropractic Care
Cancer and its treatments often cause stress on the musculoskeletal system. Some cancer patients experience peripheral neuropathy, aches and pains in the neck and/or back, muscle tension, headaches or difficulty walking. Chiropractic care may help to reduce stress and increase mobility, flexibility, strength and function.
Hands-on Healing / Healing Touch
This study The Clinical Effectiveness of Healing Touch, included twenty-two (22) clients who had never experienced Healing Touch. It concluded: The data support the clinical effectiveness of Healing Touch in health enhancement, specifically for…lowering stress perceptions and relieving pain.
Hypnotherapy
Hypnosis has been suggested to be a useful adjunct for pain reduction in cancer patients and can significantly reduce cancer-related pain, antiemetic use, nausea and emesis (vomiting) during medical procedures, as well as anxiety related to all of the mentioned symptoms occurring in cancer patients.
Massage
Studies have shown that a massage will decrease stress, anxiety, depression, pain, and fatigue. Therefore, it is very beneficial in any cancer protocol. The connection among physical well-being, touch, and relaxation is very strong and can enhance the body’s own abilities to heal.
Progressive Muscle Relaxation
Reports of patients who participated in PMR training following cancer treatment indicate that they experienced reduced state anxiety, pain, and symptoms of depression, as well as improvements in sleep parameters and overall quality of life.
Pulsed Electromagnetic Field (PEMF) therapy
Pulsed Electromagnetic Field (PEMF) therapy is a safe, and non-invasive way to reduce pain and inflammation. It can be used to supplement and enhance currently existing healthcare modalities.
Reiki
Reiki is a natural non-invasive therapy that promotes healing through stress reduction, relaxation and balancing of your energy systems. Reiki helps the muscles and tissues relax resulting in an increase in the blood flow to the treated area. This helps to reduce stress and pain and quickens the healing process.
Reflexology
A small study funded by the National Cancer Institute found that the ancient therapy may be an effective way to deal with cancer-related pain.
Tai Chi
People practice tai chi for various health-related purposes, such as:
- To ease pain and stiffness—for example, from osteoarthritis
- To improve sleep
- For overall wellness.
Herbs
Turmeric
White Willow Bark
California Poppy
Corydalis
Red Pepper
Noni Root
Kava / Kava Lactones
Fatigue
Fatigue experienced by cancer patients is a persistent, overwhelming sense of physical, emotional, and cognitive exhaustion that is disproportionate to activity and not relieved by rest. It affects 40–100% of patients, depending on treatment type, and often continues long after treatment ends
L-Carnitine (LC) L-carnitine is a naturally occurring amino acid derivative that’s often taken as a supplement.
This study says: LC supplementation improved general fatigue in all cancer patients during chemotherapy. LC may improve the ability of cancer patients to cope with chemotherapy by reducing general fatigue and improving the nutritional status.
Red ginseng
This study says ginseng consumption alleviates Cancer Related Fatigue and may have certain benefits in improving Quality of Life especially physical well-being.
Insomnia
Sleep Disturbance: Difficulty sleeping and disturbed sleep are among the most distressing symptoms, reported by 96.4% in some cohorts.
Cognitive Behavioral Therapy (CBT)
Study published in Breast Cancer: Basic and Clinical Research says: Cognitive behavioral therapy for insomnia is one of the most effective therapeutic modalities for sleep disturbance in patients with breast cancer and has been associated with the improvement not only in patient-reported sleep measures but also in patient psychological distress levels and QOL.
Study published in Current Sleep Medicine Reports says: Several clinical trials have supported the efficacy of CBT to improve sleep of cancer patients. CBT is now recognized as the treatment of choice for insomnia comorbid with cancer.
Chemotherapy-induced Peripheral Neuropathy (CIPN)
Chemotherapy-induced peripheral neuropathy (CIPN) is one of the most frequent side effects caused by antineoplastic agents, with a prevalence from 19% to over 85%. (CIPN) symptoms vary from patient to patient, but in general, side effects include:
• feeling of numbness or “pins and needles” in your hands and feet;
• ringing in your ears or loss of hearing;
• changes in vision;
• sudden, stabbing pains in your hands or feet;
• muscle weakness or cramps; The following can help:
Ice cap, frozen socks and gloves
This study of 36 patients published in The Journal of the National Cancer Institute says: Breast cancer patients treated weekly with paclitaxel (80 mg/m2 for one hour) wore frozen gloves and socks on the dominant side for 90 minutes, including the entire duration of drug infusion. The researchers found that the hands and feet that wore the frozen gloves and socks had less loss of sensitivity to touch and temperature than the hands and feet that didn’t wear the frozen garments:
Omega-3 fatty acids
Study of 57 breast cancer patients published in the Journal of Clinical Oncology says: Omega-3 fatty acids may be an efficient neuroprotective supplement for prophylaxis against PIPN. They were able to reduce the incidence of PIPN [paclitaxel-induced peripheral neuropathy] in these study patients.
Sweet bee venom
Study Review says: A total of 11 eligible consecutive CIPN patients were treated for 3 weeks and observed for another 3 weeks. A significant intraindividual improvement was found for pain and neuropathy scales.
Chai Hu Long Gu Mu Li Wan
Study Review found the incidence of CIPN was almost halved in the patients treated with Chinese herbs in addition to paclitaxe compared to those treated with paclitaxe alone.
Goshajinkigan
Study of 29 patients published in Experimental and Therapeutic Medicine suggests that Goshajinkigan inhibits the progression of peripheral neuropathy.
Study of 82 patients says: We have also found that Gosya-jinki-gan was possibly effective for the treatment and the prevention of peripheral neuropathy. Additionally Gosya-jinki-gan might be more effective for peripheral neuropathy when it is administered from the beginning of chemotherapy including Paclitaxel.
Grains and Citrus Fruits
Study of 1468 patients published in Breast Cancer Research says: we observed significant inverse associations between neuropathy and consumption of grains, and marginally significant positive associations with consumption of citrus fruits.
Vitamin E
Meta-Analysis involving 555 patients: Available data included in this meta-analysis showed that vitamin E supplementation can confer modest improvement in the prevention of CIPN.
Meta-Analysis (319 patients) published in International Journal for Vitamin and Nutrition Research says: …vitamin E supplementation had a significant effect on CIPN prevention.
Study of 27 patients published in Journal of Clinical Oncology says: The severity of neurotoxicity, measured with a comprehensive neurotoxicity score …was significantly lower in patients who were supplemented with vitamin E than in patients who were not supplemented with vitamin E.
Capsaicin patch
Study of 16 patients published in Journal of Pain Research says:In this study, CIPN patients reported significant pain reduction following a single 30 min treatment with the capsaicin 8% patch – in spontaneous pain, touch-evoked pain and cold-evoked pain… Capsaicin 8% patch provides significant pain relief in CIPN, and may lead to nerve regeneration and restoration of sensory nerve fibers ie, disease modification.
Magnesium
Study of 196 colorectal cancer patients published in Nutrients says: Magnesium intake during chemotherapy was statistically significantly associated with lower prevalence of CIPN…Furthermore, higher dietary intake of magnesium during and after chemotherapy was associated with less severe CIPN.
N- acetylcysteine
Study of 14 stage III colon cancer patients published in Supportive Care in Cancer says: We concluded that oral N-acetylcysteine reduces the incidence of oxaliplatin induced neuropathy in colon cancer patients receiving oxaliplatin-based adjuvant chemotherapy.
Alpha-lipoic acid
National Cancer Institute
A substance that is being studied for its ability to protect normal cells from the side effects of chemotherapy and prevent peripheral neuropathy (numbness, tingling, burning, and weakness in the hands or feet).
According to Stanford Medicine there are no known food or medicine interactions. But ALA can reduce the amount of insulin or oral diabetes medicine needed. If you have diabetes and use ALA, watch your blood sugar levels closely
Loss of appetite and weight loss
Appetite loss is cited by up to 76% of patients, often leading to unintended weight loss.
Cannabis
Study: Nausea, appetite loss, pain, and anxiety are all afflictions of wasting, and all can be mitigated by marijuana.
Study published in European Journal of Cancer states: … this study shows that MLT may counteract weight loss that occurs with progressing cancer…
Omega 3 Fatty Acids
Study published in Current Problems in Cancer says: patients with the lowest n-3 fatty acids in plasma PL experience muscle loss whereas those with the highest n-3 fatty acids gain muscle over the course of chemotherapy.
Study published in GUT states: In cancers where high inflammatory stress is usual, protein rich supplements containing n-3 polyunsaturated fatty acids and high levels of antioxidant vitamins can reverse severe weight loss.
Hydrazine Sulfate
A substance that has been studied as a treatment for cancer and as a treatment for cachexia (body wasting) associated with advanced cancer. Source: National Cancer Institute.
Study: Dr. Joseph Gold, an American research oncologist, found that in clinical studies, the use of hydrazine sulfate resulted in improved appetite and reduced weight loss, and he proposed that it be used as an adjuvant therapy to prevent cachexia.
Low carbohydrate diet
Study published in BMC Medicine says: a switch to a low carbohydrate/ketogenic diet has been shown to prevent cachexia in patients undergoing chemotherapy, suggesting this dietary approach may be a suitable alternative for cancer patients at risk of cachexia, sarcopenia, and weight loss.
Megestrol
A drug used to treat advanced breast and endometrial cancer. It is also being studied in the treatment of anorexia and cachexia in patients with cancer – National Cancer Institute.
Study published in Radiotherapy and Oncology says: Megestrol acetate can significantly decrease the degree of body weight loss, and can prevent the deterioration of appetite in patients with head and neck cancers receiving radiotherapy.
More at Cachexia page
Memory Loss (“chemo brain”) and Cognitive Problems
Memory Loss (“chemo brain”) and Cognitive Problems: Nearly half report memory loss or trouble concentrating, attributing it to treatment side effects.
Physical Exercise
Study published in Neuropharmacology says: Our findings suggest that low-intensity exercise may aid in preventing or attenuating cognitive dysfunction in patients with various forms of cancer undergoing chemotherapy.
Neurofeedback
A treatment being studied to improve brain function in certain brain disorders and in patients treated with chemotherapy for breast cancer…Neurofeedback may help cancer patients deal with the stress and mental side effects of chemotherapy. – National Cancer Institute.
Study published in Integrative Cancer Therapies says: After 10 weeks (20 sessions) of neurofeedback, their performance in these areas had improved to levels indistinguishable from population norms.
BrainHQ
BrainHQ is an online brain-training program made by Posit Science. In late 2018, the National Cancer Institute recognized BrainHQ as an evidence-based cancer intervention. The NCI database describes it as an intervention designed to help breast cancer survivors troubled by chemo brain – National Cancer Institute.
Study published in Journal of the American Geriatrics Society says: Auditory Memory/Attention improvement was significantly greater in the experimental group [using BrainHQ games]than in the control group. Multiple secondary measures of memory and attention showed significantly greater improvements in the experimental group, as did the participant-reported outcome measure.
Reduce Nausea and Vomiting
A number of drugs are used to treat nausea, but other, less toxic therapies have also been proven to help patients. These include:
Cannabinoids
Study published in British Journal of Pharmacology says: Considerable evidence demonstrates that manipulation of the endocannabinoid system regulates nausea and vomiting in humans and other animals. Nausea is often reported as more distressing than vomiting, because it is a continuous sensation. Indeed, this distressing symptom of chemotherapy treatment (even when vomiting is pharmacologically controlled) can become so severe that as many as 20% of patients discontinue the treatment.
Ginger Supplements
Study of 576 patients published in Supportive Care in Cancer concluded: Ginger supplementation at daily dose of 0.5g-1.0g significantly aids in reduction of the severity of acute chemotherapy-induced nausea in adult cancer patients.
Study published in The Asian Pacific Journal of Cancer Prevention says: According to the findings of this study, it should be declared that taking ginger capsules (1 g/day) might relieve Chemotherapy-induced nausea and vomiting safely.
Hypnosis
Study: Evidence has shown that hypnosis can effectively treat anticipatory Chemotherapy-induced nausea and vomiting and early research indicates that alternative treatments such as acupuncture and massage may also be beneficial in prevention of Chemotherapy-induced nausea and vomiting.
Accupressure
Study published by Oncology Nursing Society states: With delayed nausea and vomiting, the acupressure group had a statistically significant reduction in the amount of vomiting and the intensity of nausea over time when compared with the placebo and usual-care groups.
Massage and Inhalation Essential Oils (Aromatherapy)
Study published in Cancer Nursing conluded: Nausea severity was significantly lower in the massage and inhalation aromatherapy groups than in the control group. Nausea and retching incidence was reduced in the aromatherapy groups compared with that in the control group.
Taurine
Study of 40 patients published in Academia says: The present study successfully demonstrated that taurine can decrease the incidence of chemotherapy-induced nausea and vomiting and attenuate chemotherapy-induced taste and smell impairment and fatigue in ALL [acute lymphoblastic leukemia] patients during their maintenance chemotherapy.
Other:
Avoid spicy or acidic foods such as oranges, lemons, and tomatoes. Avoid greasy foods.
Avoid all food additives, especially MSG (all forms), aspartame and carrageenan.
Drink a mixture of vegetables including: broccoli, brussels sprouts, cauliflower, celery, Chinese cabbage, kale, parsley, purple cabbage, tomatoes, turnip greens.
Oral Mucosis
Oral mucositis is a severely debilitating condition characterized by erythema, edema, and ulcerations of the oral mucosa. It is a complication of radiation therapy (RT) to the head and neck, chemotherapy, chemoradiotherapy, and hematopoeitic stem cell transplantation (HSCT).
Selenium
Studyof 77 patients published in Bone Marrow Transplantation says the results of their study showed that selenium supplementation during high-dose chemotherapy could prevent severe oral mucosis in patients undergoing bone marrow transplant.
Glutamine
Study published in Cureus concluded: glutamine significantly decreased the incidence and severity of chemo-radiotherapy-induced oral mucositis and dysphagia in patients with carcinoma of the oropharynx and larynx…glutamine significantly delayed the onset of oral mucositis and dysphagia. Glutamine improved the compliance to chemo-radiotherapy treatment and reduced the chances of hospitalisation for the management of treatment-induced toxicities.
Honey, Zinc, Selenium, Vitamin E, and Glutamine
Review of fifty studies published in Integrative Cancer Therapies says: There is plausible clinical evidence for the administration of honey, zinc, selenium, topical vitamin E, and glutamine as an adjuvant treatment to reduce the risk of developing oral mucositis during chemotherapy or radiotherapy.
Methylene blue (MB)
This 2022 study says:
Sixty patients completed the study. Compared with those who received conventional therapy alone, those who received MB had a significant reduction of pain scores at day 2 of treatment …and reduction of oral function burden scores…No serious adverse events were noted, but eight patients reported burning sensation of the oral cavity with the first dose, and this caused one patient to discontinue therapy. Conclusions: MB oral rinse showed significant pain reduction and improved oral functioning with minimal adverse effects.
The following can also help:
Avoid hot foods
Avoid spicy foods
Make sure your dentures fit properly
Do not smoke
Do not drink alcohol
Use a soft toothbrush and brush gently
Use a mouthwash compound from grapefruit seed extract with added sweetener (Stevia)
Take CoQ10 daily
Swelling in extremities (Edema) and Lymphedema
Source: MedlinePlus.
Some tips that may help reduce swelling:
- Put your legs on pillows to raise them above your heart while lying down.
- Exercise your legs. This helps pump fluid from your legs back to your heart.
- Follow a low-salt diet, which may reduce fluid buildup and swelling.
- Wear support stockings (sold at most drugstores and medical supply stores).
- When traveling, take breaks often to stand up and move around.
- Avoid wearing tight clothing or garters around your thighs.
- Lose weight if you need to.
Reduces Cerebral Edema (swelling)
Boswellia Serrata
Reduces Lymphedema
Selenium (Sodium Selenite)
Updated January 2025