Patient Blogs | Breast Cancer
What I Learned About Managing Breast Cancer Pain
photo of woman holding breast

“Pain” was the first thought I had upon learning that I had breast cancer. “Oh, this is going to be painful.” Long before I knew anything about my cancer type or staging or what treatment was recommended, I knew there was no way this wasn’t going to be painful. I didn’t know what kind of pain or how bad it would be, but I intensely feared it.

Early on, my oncologist and my breast surgeon asked me what I was most worried about, to which I replied: pain. Both acknowledged this journey would not be pleasant, but they reassured me about all the comforts that were available to make it as tolerable as possible. Their validation and support got me to my first day of chemo, my first time on an OR table, and straight through to the end of all of it.

When I was told I needed a port for chemo, my fear was not the placement but the process of accessing it for chemo. The morning of my first chemo, I slathered on way too much lidocaine. No amount seemed like it could be adequate. When it was time, I sat up, heart racing, eyes wide open and focused on my port, just 4 days fresh from placement. Then I stopped staring, recognizing that the needle was going in whether I watched it or not, and considered trying something new: looking away. Focusing on the blue tile of the ceiling, I slowed my breathing to deep and smooth movements of air. And it was done, my port was accessed. I hadn’t really noticed. I learned the power of breathing and attention redirection (or distraction) in my experience of pain.

Through my treatments, I noticed that the interventions I was most anxious about being painful weren’t as awful as what I had built up in my mind. Rather, some of the more painful experiences were the less expected ones. For instance, when a radiotracer was injected into my right breast the morning of my mastectomy, I almost bit through my tongue. I wasn’t prepared for that sting. Fortunately, it only lasted a few seconds, but I had mentally underestimated the degree of sting involved. My lungs were so tight, I gasped in a large breath and breathed it out, easing with it the sharp burn. Lying on the table for this procedure, I was so exhausted from the morning of procedures in preparation for my mastectomy that afternoon that I had forgotten to breathe properly.

Just thinking about my double mastectomy procedure in basic terms was terrifying to me. Of course, this was going to hurt. But I was committed. Worrying in my head was never helpful, so of course I told my breast surgeon. She introduced me to the pain management team, who introduced me to the thoracic paravertebral block. It’s a simple procedure they do

just before rolling you back to the OR. They placed small tubing on both sides of my thoracic (or upper back) where the nerves that provide the sensation to my chest branch from my spinal cord. Through this tubing they infused anesthetic medication, which numbed my entire chest. After my double mastectomy with reconstruction surgery, I woke up to not even a hint of soreness in my chest. I stood up, walked to use the restroom and back. Then I went home with the tubing in place, attached to two balloons of anesthetic that slowly infused over the next 7 days. I was absolutely fascinated.

Compared to my oncoplastic reduction 2 months ago, with these nerve blocks, I woke up after surgery with less pain, didn’t use any PRNs (additional “as needed” pain meds) while in the hospital, and didn’t require any post-op narcotic pain medications. The paravertebral nerve blocks were a big win for me and I’m so grateful, not only to my providers but also that I spoke up about it. I spoke up about my fear of pain, I pursued it, and they responded. 

One can assume that having cancer, receiving cancer treatment, or being a cancer survivor can be painful. Of course, my assessment of pain is a completely subjective reflection. There’s no way to compare one person’s experience of pain to another’s, yet you are not alone in what you are feeling. I found speaking about it openly and sharing my concerns with my care team benefited me greatly. A strategy was put in place that really supported me going to my treatments. When it was time, slow, deep breaths and shifting my focus helped me through my otherwise toughest moments. Cancer can be painful, but it can be managed with appropriate attention. It does not have to hinder your experience or stop your progress.

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Photo Credit: Prostock-Studio / iStock via Getty Images Plus

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Kavita Jackson, MD

Kavita Jackson, MD

Diagnosed since 2019

Kavita Jackson, MD, is a triple-negative breast cancer survivor. As a girl mom and woman of color who was diagnosed with breast cancer at age 32, she empowers other women by promoting self-breast exams, dispelling common breast cancer myths, and sharing her raw experience on the other side of medicine. Connect with her on Instagram.

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