Cancer pain may come from the cancer itself, treatment side effects, surgery, radiation, chemotherapy, nerve injury, or survivorship-related changes.
This video explains how cancer-related pain may involve nerves, treatment effects, medication planning, emotional burden, and coordinated care.
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Hi, I’m Dr. Jason Siefferman, medical director at 91视频. When we see a patient with cancer-related pain, this is a complex situation. It’s not only just the cancer itself that can cause pain, but also the treatments for the cancer. And what we have to do is really understand what is the primary pain. How did it become worse through that process? What is driving the ongoing pain? And how can we best treat it?
Treatments for cancer-related pain often involve injections because there’s generally a focal site of pain. What we need to do is confirm that site of pain and find a way to calm it down. We also use neuromodulation. Neuromodulation is electrical stimulation which can be done with peripheral nerve stimulators or spinal cord stimulators. These are tremendously helpful to offload that excessive nervous system response to either the ongoing source of pain or the leftover irritation from radiation, multiple surgeries, whatever may have occurred in that area. We also will use opioids in cancer pain because it’s difficult, it’s complex, and we want to make sure that the patient finds relief. And we will use a conscientious multimodal approach with balanced consideration of all the options to make sure that adequate relief is found.
Cancer pain can be caused by the cancer itself, cancer treatment, diagnostic procedures, surgery, chemotherapy, radiation, inflammation, nerve injury, scar tissue, medication effects, or persistent pain after treatment. Pain may be sharp, aching, burning, tingling, numb, pressure-like, or localized to a specific area.
Some patients experience pain during active treatment, while others develop chronic cancer-related pain during survivorship. Because cancer pain can have several physical and emotional layers, care should begin with understanding the source of pain, current cancer status, treatment history, medications, function, and goals of care.
At 91视频, cancer pain care begins with careful assessment and coordination with the patient鈥檚 oncology team. For patients looking for cancer pain management in Manhattan, MPM evaluates whether pain is related to tumor involvement, surgery, chemotherapy, radiation, neuropathy, inflammation, scar tissue, medication effects, or central pain processing.
Care may include medication management, opioid therapy when appropriate, peripheral nerve blocks, acupuncture, pain psychology, and coordination with oncology, palliative care, primary care, and mental health support. The goal is not simply to increase medication, but to understand the pain source and build a safe, individualized plan.
Cancer pain is personal and can change over time. A patient in active treatment may have pain from a tumor, surgery, chemotherapy, radiation, or diagnostic procedures. A cancer survivor may have persistent nerve pain, post-surgical pain, scar sensitivity, muscle and joint pain, or chemotherapy-induced peripheral neuropathy. Some patients also experience fear, sleep disruption, anxiety, trauma, grief, or stress related to pain and cancer treatment.
A coordinated plan matters because pain care should align with the patient鈥檚 oncology history, cancer status, prognosis, medications, treatment goals, and safety needs. MPM鈥檚 diagnosis-first approach helps identify whether pain appears nociceptive, neuropathic, post-surgical, inflammatory, treatment-related, centralized, or multifactorial. This allows care to include medical, procedural, integrative, and psychological support without reducing the pain experience to one explanation.
Cancer pain fits across MPM鈥檚 Complex Chronic Pain and Psychology of Pain Zones of Expertise. This matters because cancer pain is often both physically specific and emotionally complex. A patient may have tumor-related pain, nerve pain, post-surgical pain, chemotherapy neuropathy, radiation-related pain, or persistent pain after treatment. At the same time, the experience of cancer pain may affect sleep, fear, mood, identity, relationships, and daily function.
MPM uses the Zones of Expertise framework to evaluate the physical source of pain while also recognizing the nervous system and emotional burden of living with cancer-related pain. Pain psychology does not replace medical care. It provides an additional layer of support for coping, fear, stress, trauma, pacing, and quality of life.
I cannot say enough good things about 91视频. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional 鈥� knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
The best care I've received as a chronic pain patient. I traveled from out of state to visit 91视频 because I could not find knowledgeable doctors in my hometown for my hypermobility, and Ehlers-Danlos syndrome symptoms and comorbidities. Let me tell you, it was worth every travel e...
I was injured in a bicycle accident over 8 years ago. I鈥檝e suffered throughout the years since my accident with nothing seeming to work. PT, Yoga, lifestyle changes, NOTHNG! I finally made an appointment with Dr Kane and I鈥檓 feeling an improvement in my life. I no longer stay up all night in pain, a...
One of the best experiences, if not the best, I have ever had at the doctor鈥檚 office. From the front desk to the nurses to the PA assisting the doctor this was a great experience. Dr.Nino actually listened to me and came up with a game plan. Would recommend this practice to as many people as I could...
I have very unique & severe nerve pain from CRPS which has no known specific cure. Dr. Siefferman has a huge tool box, far greater than the other 23 Drs. I have seen. He saved me from jumping off a bridge and continues to help me with both treatments and advice. Dr. S. is in a different league!
After two years of searching and feeling lost and let down, I finally found real help at 91视频. With Dr. Siefferman, Adam Rosenberg, Dr. Mikaberidze, and the whole team, I feel heard, supported and understood. Every symptom is being considered and I鈥檓 finally getting answers with m...
Why is Dr Dr. Tayyaba Ahmed one of the top pevic Floor specialists - 1- She wants to know a full history of what led the patient to get to this point. 2 - She listens intensley to the patient 3- She does not rush you 4- Extremely skilled at giving pelvic floor injections 5- I thank my luck stars she...
The staff was friendly and helpful. Dr. Siefferman was thoughtful, listened, asked questions and proposed simple safe ways to come to further conclusions regarding my pain and discomfort. The office staff including Dr. Siefferman is responsive even after the initial in-person visit. Very pleased.
Dr. Siefferman is a brilliant provider. While my pain is still a work in progress, Dr Siefferman always gives me options and explains his reasoning behind things. He listens to my feedback and concerns. I never feel rushed; and am grateful he works to meet me where I am. I highly recommend him.
What a great find! They listen to me, I listen to them and the diagnosis is made and a plan developed to develop an approach to treat all of my chronic pain. I wish I could have discovered this type of treatment sooner. This doctor and group give me hope.
Cancer pain may be caused by the cancer itself, cancer treatment, diagnostic procedures, surgery, chemotherapy, radiation, inflammation, nerve injury, scar tissue, tumor pressure, or treatment side effects. A tumor may cause pain by pressing on bone, nerves, organs, or soft tissue. Treatment may cause pain through surgical changes, radiation injury, chemotherapy-induced nerve damage, or inflammation. Some patients continue to have pain after treatment ends. Because cancer pain can have several causes, the first step is a careful assessment of the pain pattern, cancer history, current treatment, and goals of care.
Yes. Some patients develop persistent pain after surgery, chemotherapy, radiation, or other cancer treatments. This may include nerve pain, scar-related pain, musculoskeletal pain, sensitivity in a treated area, or chemotherapy-induced peripheral neuropathy. Cancer survivors may also experience fatigue, sleep disruption, anxiety, trauma, or fear that affects how pain is experienced. Persistent pain after cancer treatment should be evaluated rather than dismissed as expected or permanent. MPM helps assess whether pain appears nerve-related, post-surgical, inflammatory, centralized, or related to another treatable contributor.
Cancer pain treatment depends on the pain source, cancer status, treatment plan, medication history, and goals of care. Options may include medication management, non-opioid medications, medications for nerve pain, opioid therapy when clinically appropriate, peripheral nerve blocks for selected localized pain, acupuncture, and pain psychology. Some patients also need palliative care, oncology-directed treatment, rehabilitation, or mental health support. Cancer pain care should be coordinated with the oncology team so medication decisions, procedures, side effects, and goals are aligned with the broader cancer treatment plan.
Yes. Opioids may be used for moderate to severe cancer pain when clinically appropriate. They may be part of a broader pain relief plan that also includes non-opioid medications, nerve pain medications, procedures, integrative support, or psychological support. Opioid therapy requires careful dosing, monitoring, side effect management, safety planning, and coordination with the oncology team. The goal is to treat pain responsibly while considering constipation, sedation, nausea, medication interactions, tolerance, risk factors, and the patient鈥檚 overall condition. Opioids are not always needed, but they should not be dismissed when cancer pain is significant.
Yes. Chemotherapy can cause peripheral neuropathy in some patients. This may feel like burning, tingling, numbness, electric pain, sensitivity to touch, weakness, or pain in the hands and feet. Neuropathy may occur during treatment and can sometimes continue after chemotherapy has ended. Nerve pain after cancer treatment should be evaluated because it may affect balance, walking, hand function, sleep, and daily activity. Treatment may include medication management, function-focused support, pain psychology, acupuncture in appropriate patients, and other strategies based on the patient鈥檚 symptoms and oncology history.
Nerve blocks may help selected cancer pain patterns, especially when pain is localized or nerve-related. A nerve block uses medication near a nerve or nerve pathway to reduce pain signals. It is not appropriate for every type of cancer pain, and the expected benefit depends on the pain source, anatomy, cancer status, prior treatments, medications, and goals of care. Mayo Clinic notes that nerve blocks may work best when pain is limited to a specific area. MPM evaluates whether a peripheral nerve block is appropriate and coordinates with oncology when procedures are being considered.
Yes. Pain psychology can support patients living with cancer pain by helping with coping, fear, sleep disruption, stress, trauma, uncertainty, pacing, and quality of life. It does not mean the pain is imaginary, and it does not replace medical pain treatment. Cancer pain can affect the nervous system, emotions, relationships, and daily function. Pain psychology gives patients tools to manage the burden of pain while medical care continues. It can also support caregivers and help patients communicate more clearly about symptoms, goals, and treatment concerns.
Cancer pain should be reported promptly to the oncology or treating medical team when it is new, severe, worsening, unexplained, or associated with fever, weakness, numbness, bowel or bladder changes, confusion, shortness of breath, chest pain, new swelling, difficulty walking, or concern for infection, fracture, spinal cord compression, blood clot, or disease progression. Patients should not wait for a routine pain appointment when symptoms suggest a possible urgent cancer-related complication. Emergency evaluation may be needed depending on the symptom pattern.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
Cancer pain is not one single type of pain. It may come from the cancer itself, cancer treatment, diagnostic procedures, surgery, chemotherapy, radiation, inflammation, nerve injury, scar tissue, medication side effects, or persistent pain after treatment. Cancer pain may be caused by cancer, treatment, or diagnostic tests, and pain may continue after treatment ends.
For some patients, pain is related to a tumor pressing on bone, nerves, organs, or soft tissue. For others, pain begins after surgery, radiation, chemotherapy, or other treatment. Some patients experience pain during active cancer care. Others develop chronic cancer-related pain during survivorship. MPM approaches cancer pain by first asking what type of pain is present and how it fits within the patient鈥檚 cancer history and current oncology plan.
Cancer pain may be nociceptive, neuropathic, inflammatory, post-surgical, treatment-related, centralized, or mixed. Nociceptive pain may come from tissue injury, inflammation, bone involvement, or organ pressure. Neuropathic pain may come from nerve damage, nerve compression, chemotherapy-induced peripheral neuropathy, surgery, or radiation. Centralized pain may develop when the nervous system remains highly sensitive after prolonged pain or treatment stress.
Pain may feel aching, sharp, burning, tingling, numb, electric, stabbing, pressure-like, or hypersensitive to touch. It may be localized to one area or spread more broadly. Some patients have predictable pain with movement. Others have breakthrough pain, pain after procedures, or pain that worsens at night. Understanding these patterns helps guide treatment.
During active cancer treatment, pain may come from the disease, surgery, chemotherapy, radiation, procedures, inflammation, or medication side effects. After treatment, pain may continue because of scar tissue, nerve injury, radiation-related changes, chemotherapy-induced neuropathy, musculoskeletal changes, or persistent nervous system sensitivity.
Chemotherapy-induced peripheral neuropathy can cause burning, tingling, numbness, sensitivity, or pain in the hands and feet. Peripheral neuropathy may be caused by chemotherapy and may continue after chemotherapy has ended. For patients, this can affect walking, balance, hand function, sleep, and independence.
MPM begins with a detailed pain assessment. This includes the cancer diagnosis, treatment history, current oncology plan, imaging, surgeries, chemotherapy, radiation, medications, allergies, side effects, pain location, pain quality, function, sleep, mood, and goals of care. MPM also reviews whether the oncology team has identified any urgent concerns such as disease progression, fracture risk, infection, blood clot, spinal cord compression, or organ involvement.
The evaluation is diagnosis-first. MPM does not assume pain should be treated only by increasing medication. The goal is to understand whether pain is nerve-related, tumor-related, post-surgical, inflammatory, musculoskeletal, centralized, or related to treatment side effects. This helps guide the safest combination of medication management, procedures, acupuncture, pain psychology, and oncology coordination.
Medication management for cancer pain may include non-opioid medications, medications for nerve pain, anti-inflammatory medications when appropriate, topical medications, and opioid therapy when clinically appropriate. Opioids may be important for moderate to severe cancer pain, but they require careful planning. This includes dose selection, monitoring, constipation prevention, nausea management, sedation risk, medication interaction review, safety planning, and coordination with the oncology team.
Some patients need short-acting medication for episodic or breakthrough pain. Others may need longer-acting medication for more continuous pain. The right approach depends on the patient鈥檚 diagnosis, pain pattern, prognosis, current treatments, risk factors, and goals. Opioids are not always necessary, but they can be appropriate and important for many patients with significant cancer-related pain.
Peripheral nerve blocks may be considered when pain is localized or nerve-related. Nerve blocks may help reduce pain signals and may work best when pain is limited to a specific area. Nerve blocks are not appropriate for every patient, but they may be part of a broader plan when anatomy, diagnosis, and goals support their use.
Acupuncture may be considered for selected patients as part of integrative cancer pain support. It should be coordinated with the oncology team, especially when patients have low blood counts, infection risk, lymphedema risk, anticoagulation, or other treatment-related concerns. Pain psychology may help patients manage the emotional and nervous system burden of pain, including fear, stress, sleep disruption, trauma, and changes in identity or function.
Cancer pain is physical, but it also affects the whole person. Pain can create fear about disease progression, anxiety about treatment, sleep loss, reduced activity, caregiver strain, and emotional exhaustion. Some patients feel pressure to minimize their pain, while others worry about taking medication or becoming dependent on it.
Pain psychology does not suggest that pain is 鈥渏ust psychological.鈥� It recognizes that pain, stress, sleep, attention, fear, and nervous system sensitivity interact. Support can help patients communicate symptoms more clearly, manage flare-related fear, improve pacing, and maintain function while medical treatment continues.
Cancer pain should be reported to the oncology or treating medical team when it is new, severe, worsening, unexplained, or associated with fever, weakness, numbness, bowel or bladder changes, confusion, shortness of breath, chest pain, new swelling, difficulty walking, or concern for infection, fracture, spinal cord compression, blood clot, or disease progression. These symptoms may require urgent evaluation and should not wait for a routine pain visit.
MPM approaches cancer pain through a coordinated, diagnosis-first model. The evaluation considers the cancer history, current treatment plan, prognosis, medications, pain type, function, emotional burden, and patient goals. Care may involve medication management, opioid therapy when appropriate, peripheral nerve blocks, acupuncture, pain psychology, and communication with oncology, palliative care, primary care, rehabilitation, or mental health support.
For patients looking for cancer pain management in Manhattan, MPM offers a careful, compassionate approach to pain during treatment, after treatment, and during survivorship. The goal is to help clarify the source of pain, support safer treatment planning, improve function where possible, and coordinate care around the patient鈥檚 needs and goals.
