No one likes to be a pain. But talking about the pain you feel as a cancer patient is the first big step toward feeling better. Much better.

“Cancer patients put all sorts of barriers up,” said Dr. Melanie Simpson, pain management specialist. “They are living normal, healthy lives, and all of a sudden this beast comes along that changes everything. Getting them to tell us how they feel is sometimes really difficult, but once they talk about it, we can help them.”

As many as 40% of cancer patients experience pain at the time of diagnosis, and up to 85% have pain if the cancer has spread. With the pain comes fear, because patients immediately think something is wrong, that the pain is a signal that the disease is progressing. The good news is that 95% of cancer pain can be treated successfully.

“We have all the tools to make people comfortable,” said Simpson. “We take the time to do a good assessment and find out where to start. Patients need to describe their pain so we know what we’re dealing with. And if someone tells me, ‘I’ve tried everything’, believe me, I have many other options for them that they haven’t tried.”

Pain can come from a tumor, surgery, radiation therapy or chemotherapy. Doctors can treat the pain by reducing inflammation at the source, changing the perception of pain with medications, or by using spinal treatments or nerve blocks to interfere with the pain signals sent to the brain.

The World Health Organization developed an analgesic treatment ladder that calls for mild pain to be treated with nonopioid analgesics, moderate pain with a combination of weak opioids like Hydrocodone, and more severe pain to be treated with strong opioid medications, such as Morphine.

There are many different kinds of opioids for cancer pain, but several new products are now on the market. Oxymorphone used to be available only in injectable form; now it is sold as an oral tablet in both short and long-acting formulations. An emerging opioid, Tapentadol, is a whole new molecule that gives doctors another option for pain management.

“Many patients have nausea or vomiting the first time they take an opioid, so they never want to take another one,” said Dr. Simpson. “But most bodies adjust to it within 72 hours.”

There are many ways to manage pain without medication. Physical therapy can ease pain with the use of prostheses, splints or braces. Relaxation, distraction and hypnosis help patients use their minds to control body responses.

“We use guided imagery, asking patients to close their eyes and think about their favorite place,” said Dr. Simpson. “It is very powerful and helps distract them from the pain.”

Using heat and cold directly on the pain also works well, and acupuncture is popular with patients who prefer not to take medication. Music therapy has been shown to reduce the heart rate, prompting more rapid healing.

“We do massage therapy, and also pet therapy,” said Dr. Simpson. “If pets are important to a patient, we bring dogs or cats in and they pet them. It is incredibly therapeutic.”

Cancer patients should be aware that there is an enormous arsenal of tools available for pain medication. Talking with your doctor about exactly what type of pain you are experiencing is the first step to getting rid of that pain.

“When I talk to patients about their pain, I can develop the best plan,” said Dr. Simpson. “I can take that pain right out of the picture, and they won’t have to worry about it.”