Not everyone with cancer has pain, but approximately three in 10 people with cancer who are having treatment will have pain. When the cancer is advanced (has come back or spread), around seven in 10 people will have pain.

Pain may occur for a number of reasons:

• A cancer may press on the tissues around it, or on a nerve.
• Infection can cause pain by creating inflammation in the affected part of the body.
• Damage to tissues following surgery or radiotherapy may lead to pain.
• A cancer may spread from its original (primary) place in the body to form other tumours (secondaries or metastases). These may cause pain, especially in the bones.
• Sometimes, pain is felt in parts of the body far away from the cancer that is causing it. This type of pain is called referred pain.

If you develop a new ache or pain, you may understandably worry this that is a sign that the cancer has come back, is getting worse, or has spread, but this is not necessarily the case.

Emotions such as fear, anxiety, depression and tiredness can make your pain worse. This does not mean that cancer pain is 'all in the mind'.

Symptoms of many physical illnesses, including asthma, heart disease and stomach ulcers can be made worse by emotional upset. In all these conditions, as with pain from cancer, it is important to treat the emotional as well as the physical causes of the problem.

Sometimes pain can be made worse by social or work-related events that cause you stress – for example, not being able to see friends, or the loss of a job.