For people living with metastatic breast cancer, managing pain and other symptoms often depends on how much the cancer has spread to other parts of the body and the location of the tumors. It is important to maintain open and honest communication with your health care team about any symptoms or pain that you are experiencing to help improve your quality of life.

Talking to Your Doctor About Pain

Good communication with your doctor will help improve the quality of the care you receive. These are some of the things to discuss with your health care team and some of the questions they may ask you if you’re experiencing pain:

When and where is your pain? You may experience pain in more than one place in your body. Your doctor needs to understand the cause of pain in each place. Was there a particular event that led to the pain?

What does the pain feel like? For example, is it dull, sharp, burning, pinching or stabbing?

What is the intensity of your pain? Different pain scales can help you rate your pain. The simplest and most common scale goes from 0 to 10, with 0 equaling no pain and 10 equaling the worst pain possible.

Does anything make the pain worse? Does standing or sitting make it hurt more? Is it worse at night, for example, and better during the day?

Does anything relieve the pain? Do you feel better if you apply ice or heat to the area or if you lie down or walk around?

How much relief are you getting from pain medication? Does your pain medication provide you with enough relief? Does it wear off before it’s time for your next dose? Are you having any unpleasant side effects?

Are you having any breakthrough pain? How many such episodes of breakthrough pain do you have? When do they occur? How long do they last? What makes them better?

Keep a Pain and Symptom Journal

By writing down any symptoms or side effects that you experience on a daily basis, it can help inform you and your health care team about how to improve your care. As a result of keeping a treatment journal, you may notice patterns in the onset of pain and symptoms that you didn’t notice before. Some of the things you may want to write down in your journal regarding treatment side effects may include:

  • When the side effect occurred and for how long
  • How strong was the discomfort/pain on a scale of 1-10
  • How the side effect impacts your daily activities
  • Contact information for each member of your health care team
  • When to call your doctor and/or go to the emergency room with a symptom

Managing Symptoms and Treatment Side Effects

Side effects and symptoms can vary from person to person and can be treated by your health care team. A key to managing side effects is to be aware of them and communicate with your health care team when they arise. Report them right away—don’t wait for your next appointment.

Pain. There are a number of options for pain relief, including prescription and over-the-counter medications. It’s important to talk to a member of your health care team before taking any over-the counter medication, to determine if they are safe and will not interfere with your treatments. Many pain medications can lead to constipation, which may make your pain worse. Your doctor can prescribe medications that help to avoid constipation. Physical therapy, acupuncture, and massage may also be of help in managing your pain. Consult with a member of your health care team before beginning any of these activities.

Fatigue. Start a gradual exercise program. Walking can improve your strength and energy level and can also improve blood flow, which decreases the risk of blood clots. Exercising and stretching the legs and ankles improves blood circulation.

Lymphedema. Women with breast cancer who have undergone lymph node removal and/or radiation as part of their treatment are at risk for developing lymphedema, a condition in which the body’s lymphatic fluid is unable to circulate properly. The lymphatic fluid builds up in soft tissues (usually in an arm or a leg), causing painful swelling. In addition to swelling of the affected limb, the most common problems associated with lymphedema are pain, hardening of the skin, and loss of mobility. Read CancerCare’s fact sheet titled, “Coping With Lymphedma” for more information.

Hot Flashes. Breast cancer treatments can lead to menopausal symptoms, such as hot flashes and night sweats. If you are experiencing these side effects, speak with your health care team about ways to cope with them. The following tips may also help:

  • Identify the triggers for your hot flashes. For many women, hot flashes can be triggered by stress, a hot shower, caffeine, or spicy foods.
  • Dress in layers and keep ice water handy to cool yourself off.
  • Avoid synthetic materials, especially at nighttime; wear pajamas and use sheets made of cotton instead.
  • Take a cool shower before going to bed.

Emotional distress. Sometimes, talking with a family member, friend or loved one can help. You may also benefit from the help of a professional oncology social worker. CancerCare’s oncology social workers can also help. Oncology social workers are licensed professionals who counsel people affected by cancer, providing emotional support and helping people access practical assistance. To learn more, visit www.cancercare.org or call 800-813-HOPE (4673).

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This fact sheet has been made possible by Cascadian Therapeutics.

Last updated June 14, 2017

The information presented in this publication is provided for your general information only. It is not intended as medical advice and should not be relied upon as a substitute for consultations with qualified health professionals who are aware of your specific situation. We encourage you to take information and questions back to your individual health care provider as a way of creating a dialogue and partnership about your cancer and your treatment.

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