Cancer-related pain is not limited to the body

Cancer-related pain is not limited to the body

Cancer-related pain cannot be reduced to the effects of the disease or its treatments. For people with an immigration background, it is also shaped by migration, religion, culture, social relationships, family responsibilities, and living conditions. A recent review of the scientific literature shows that the experience of pain is influenced by many factors that go beyond the body.

“If we take two people living with the same pain, will they have the same experience? Not necessarily. Why?”

Because each person has a different story. For some, pain is accompanied by isolation, family responsibilities, difficulty communicating, or barriers to accessing care; for others, it is eased by a support network or a better understanding of the healthcare system. In this way, the same pain can be experienced, expressed, and managed very differently from one person to another. That is why it is essential to offer care adapted to each person’s reality.

When migration shapes the experience of pain: the importance of health equity.

Receiving a cancer diagnosis while living in a host country can represent an additional challenge. People with an immigration background may face various realities that influence their experience of pain and their care journey, including:

• difficulty expressing themselves in French or English;
• limited knowledge of the healthcare system;
• separation from family and support networks;
• cultural differences in how pain is understood or expressed;
• economic or work-related difficulties;
• experiences of discrimination, stigmatization, or misunderstanding.

These realities can make it harder to communicate pain, delay help-seeking, and make access to care tailored to individual needs more difficult.

Why do we talk about health equity?

Because we do not all start from the same place. Language, culture, gender, migration history, living conditions, and the support available can all influence the experience of pain and access to care. What happens when these realities are not considered? Some people may have their pain minimized, misunderstood, or insufficiently treated.

Conversely, what can be done?

Care can be provided in ways that take into account the diversity of life experiences. This includes culturally safe care, adapted communication, interpretation services, support in navigating the healthcare system, and care centered on each person’s needs. These approaches foster better communication, strengthen trust, and contribute to fairer and more equitable pain management.

Pain is also a social and cultural experience

Is pain only physical? No.

Our values, culture, upbringing, and the expectations of those around us also influence how we experience and express pain.

Some people prefer to continue fulfilling their responsibilities despite the pain. Others hesitate to talk about their suffering so as not to worry their loved ones. For some women, caring for the family remains a priority despite the pain. For some men, expectations related to strength and autonomy can make it more difficult to ask for help. Why is this important? Because pain is not experienced in the same way by everyone. Understanding each person’s social and cultural context makes it possible to offer care that is better suited to their reality.

What helps people through the ordeal

Despite the difficulties encountered, several resources can help people live better with cancer-related pain. Participants identified in particular:

• family support;
• support groups;
• friendships and community;
• spirituality and faith;
• adapted physical activity;
• relaxation and meditation practices.

These resources play an important role by reducing isolation, promoting emotional well-being, and helping people regain a sense of control over their lives.

How can more inclusive care be offered?

Recognizing the diversity of pain experiences is an essential step toward more equitable care.

Healthcare professionals can in particular:

• promote communication adapted to the person’s language;
• use interpretation services when necessary;
• explore the person’s family, cultural, and migration context;
• recognize different ways of expressing pain;
• avoid generalizations or cultural stereotypes;
• collaborate with community organizations that support immigrants.

A person-centered approach makes it possible to better understand individual needs and provide support that is more humane and better adapted.es besoins individuels et d’offrir un accompagnement plus humain et plus adapté.

Article written by Nataly R. Espinoza Suarez, MD, PhD candidate in community health

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References

• Espinoza Suarez, N. R., et al. (2026-en revision). Uncovering the experience of immigrants living with cancer-related pain: A scoping review.
• Al-Atiyyat, N. M. H. (2009). Pain, coping strategies, and quality of life in Arab American cancer patients. Wayne State University.
• Booher, A., Mao, J. J., Muniz, R. C., Romero, S. A., Li, S. Q., Lopez, A. M., & Liou, K. T. (2024). Association between hispanic ethnicity and greater expectation of benefit from acupuncture or massage for pain in cancer. Journal of immigrant and minority health,26(5), 953-957.
• Chee, W., & Im, E.-O. (2022). Sub-ethnicity and survivorship experience: Asian American breast cancer survivors. Western journal of nursing research,44(12), 1108-1116.
• Cho, D., Chu, Q., & Lu, Q. (2018). Associations among physical symptoms, fear of cancer recurrence, and emotional well-being among Chinese American breast cancer survivors: a path model. Supportive Care in Cancer,26(6), 1755-1761.
• Davis, A. L. (2014). New Mexican Hispanic Latinos’ perspectives on cancer pain: Meaning, coping, and barriers to relief. The University of Utah.
• Edrington, J. (2007). The experience of cancer pain and barriers to cancer pain management in a community sample of Chinese American cancer patients. University of California, San Francisco.
• Edrington, J., Sun, A., Wong, C., Dodd, M., Padilla, G., Paul, S., & Miaskowski, C. (2010). A pilot study of relationships among pain characteristics, mood disturbances, and acculturation in a community sample of Chinese American patients with cancer. Oncology Nursing Forum,
• Eversley, R., Estrin, D., Dibble, S., & Wardlaw, L. (2005). Post-treatment symptoms among ethnic minority breast cancer survivors. Oncology nursing forum,
• Fu, O. S., Crew, K. D., Jacobson, J. S., Greenlee, H., Yu, G., Campbell, J., Ortiz, Y., & Hershman, D. L. (2009). Ethnicity and persistent symptom burden in breast cancer survivors. Journal of Cancer Survivorship,3(4), 241-250.
• Fukui, J., Bantum, E., Meister, M., Lim, S., Marumoto, A. D., & Pagano, I. (2021). A cross-sectional study of breast pain in a diverse population of breast cancer patients. Journal of psychosocial oncology research and practice,3(3), e055.
• Im, E.-O., Chang, S. J., & Chee, E. (2014). Predictors of quality of life in cancer survivors: White and Asian American women. Women & therapy,37(3-4), 282-300.
• Im, E.-O., Chee, W., Guevara, E., Liu, Y., Lim, H.-J., Tsai, H.-M., Clark, M., Bender, M., Kim, K. S., & Kim, Y. H. (2007). Gender and ethnic differences in cancer pain experience: a multiethnic survey in the United States. Nursing research,56(5), 296-306.
• Im, E.-O., Guevara, E., & Chee, W. (2007). The pain experience of Hispanic patients with cancer in the US. Oncology Nursing Forum,
• Im, E.-O., Ho, T.-H., Brown, A., & Chee, W. (2009). Acculturation and the cancer pain experience. Journal of Transcultural Nursing,20(4), 358-370.
• Im, E.-O., Ko, Y., & Chee, W. (2013). Symptom clusters among multiethnic groups of cancer patients with pain. Palliative & Supportive Care,11(4), 295-305.
• Im, E.-O., Lee, S. H., Liu, Y., Lim, H.-J., Guevara, E., & Chee, W. (2009). A national online forum on ethnic differences in cancer pain experience. Nursing research,58(2), 86-94.
• Im, E.-O., Liu, Y., Kim, Y. H., & Chee, W. (2008). Asian American cancer patients’ pain experience. Cancer Nursing,31(3), E17-E23.
• Juarez, G., Ferrell, B., & Borneman, T. (1998). Influence of culture on cancer pain management in Hispanic patients. Cancer practice,6(5), 262-269.
• Koffman, J., Morgan, M., Edmonds, P., Speck, P., & Higginson, I. (2008). Cultural meanings of pain: a qualitative study of Black Caribbean and White British patients with advanced cancer. Palliative medicine,22(4), 350-359.
• Krok-Schoen, J. L., Fernandez, K., Unzeitig, G. W., Rubio, G., Paskett, E. D., & Post, D. M. (2019). Hispanic breast cancer patients’ symptom experience and patient-physician communication during chemotherapy. Supportive Care in Cancer,27(2), 697-704.
• Lo, G. T. (2012). Do daily spiritual experiences buffer the effects of stoicism and fatalism on psychological distress and treatment seeking in a Chinese American cancer sample with pain? Fordham University.
• Maly, R. C., Liu, Y., Leake, B., Thind, A., & Diamant, A. L. (2010). Treatment-related symptoms among underserved women with breast cancer: the impact of physician–patient communication. Breast cancer research and treatment,119(3), 707-716.
• Martinez, K. A., Snyder, C. F., Malin, J. L., & Dy, S. M. (2014). Is race/ethnicity related to the presence or severity of pain in colorectal and lung cancer? Journal of Pain and Symptom Management,48(6), 1050-1059.
• Mathias, L. H. (2017). The Embodied Experience of Pain: A Phenomenological Study of Pain in Adults Diagnosed with and Treated for Cancer University of Miami].
• Pandey, D., Lam, K., Cheung, W., Mahmood, A., Hicks, S., Portenoy, R., Chen, J., & Dhingra, L. (2021). Prevalence of psychological symptoms in community-dwelling Chinese American patients with chronic cancer pain. Journal of immigrant and minority health,23(4), 707-716.
• Stein, K. D., Alcaraz, K. I., Kamson, C., Fallon, E. A., & Smith, T. G. (2016). Sociodemographic inequalities in barriers to cancer pain management: a report from the American Cancer Society’s Study of Cancer Survivors‐II (SCS‐II). Psycho‐Oncology,25(10), 1212-1221.
• Stephenson, N., Dalton, J. A., Carlson, J., Youngblood, R., & Bailey, D. (2009). Racial and ethnic disparities in cancer pain management. Journal of National Black Nurses’ Association: JNBNA,20(1), 11-18.
• Wang, C., Wong, C. C., & Lu, Q. (2018). The pain of ambivalence over emotional expression. International Journal of Behavioral Medicine,25(2), 216-222.
• Xu, X., Luckett, T., Lovell, M., & Phillips, J. L. (2023). Cultural factors affecting Chinese migrants’ perceptions and responses to cancer pain and its pharmacological management: A convergent mixed-method study. Palliative & Supportive Care,21(4), 688-696.