Advice and help on how to deal with pain and other symptoms is a very important part of the care for people with cancer. There are doctors and nurses throughout the country who specialise in these aspects of treatment, which is called palliative care or supportive care. They are based in hospitals, hospices, palliative care units and pain clinics, and work with you, your GP, district nurses and other health professionals to make sure that your pain is controlled.

There are also specialist palliative care teams of doctors and nurses who can visit you in your home. They can ensure that your pain is well controlled and that you are getting help and support.

Physiotherapists and occupational therapists can also help to find ways of reducing your pain; your doctor can arrange for you to see them.

When you are at home, your GP and district nurse are responsible for your healthcare. Free specialist help is available from clinical nurse specialists in palliative care (some of whom are Macmillan nurses) and specialist palliative care doctors. The specialist doctors and nurses work with you, your GP, district nurse and other health professionals. They give advice and guidance on pain and other symptoms, including psychological distress in cancer patients and their families. These specialist palliative care teams may be based at your local hospice or hospital.

The Marie Curie Nursing Service is provided by both registered nurses and care assistants. They provide palliative nursing care to people in their own homes, giving direct care and support and respite for carers. They will stay for a period of time during the day or the night. Your district nurse or palliative care nurse will be able to give you details.

What is available will depend on where you live. Whatever the system in your area, the most important thing is that you, your family, your GP and the specialist services know who is supervising your pain control and who you should contact if you have pain or other symptoms. Day and night you should be able to get help and advice, by telephone or in person.

Hospices and palliative care units specialise in the care of people with cancer or other advanced health conditions. Some are run by independent charities or by Marie Curie Cancer Care (known as Marie Curie Hospices). Others are in local NHS hospitals. These units provide a variety of care – inpatient, outpatient and day care. Most work closely with specialist pain centres.

Often, people with cancer spend a few days or weeks in a hospice having their pain, symptoms and other problems treated. They can then go home to the care of their GP and community-based nurses, with the help, support and advice of the hospice home-care team. Your GP will know of the hospice services available in your area.

Alternatively, people with cancer who cannot look after themselves at home and have no regular carers, might occasionally spend longer periods in a hospice.

As well as care from your consultant and the ward staff, specialist advice is available from the hospital-based palliative care team. This consists of clinical nurse specialists and doctors who specialise in symptom control for people with cancer in hospital.

Pain centres specialise in the treatment of all types of chronic pain, not just pain due to cancer. They are usually part of district general hospitals and are under the supervision of one or more consultant anaesthetists. The doctors and nurses who work in pain centres are skilled in using all the methods of pain control discussed in this section, but specialise in the use of nerve blocks. People are usually seen as outpatients to sort out specific pain problems that might be relieved by nerve blocks, TENS or acupuncture.