Pain medication can affects patients in various ways. If you are experiencing feelings of paranoia, speak to the prescribing physician right away. He will be able to provide relief.
Yes, the best alternative is exercise, namely yoga. I do Bikram yoga and it works extremely well. Sessions are about 75 minutes but they will clear your mind and alleviate any paranoia feelings.
You need to speak to your oncologist or advocate so they can balance your meds- many pain meds do cause a feeling of anxiety or paranoia, this can be helped.
Considering paranoia is a symptom of anxiety, any pharmaceutical anxiety medication would alleviate the negative thoughts. Notably, benzodiazepines would be sufficient for this, but they risk a strong addiction potential.