Over three-quarters of Cain's MLB appearances came as a starting pitcher, and during his career, he amassed 58 complete games and two shutouts. Although his won–lost record was only 53–60 (.469) with an earned run average of 4.83, he posted seasons of 13 (1933) and 15 (1936) wins. However, Cain exhibited poor control of his repertoire, allowing more than 100 bases on balls for three straight seasons (1933–1935), leading the American League in walks issued (123) in 1935, and averaging 5.2 walks per nine innings pitched over his big-league career. Altogether, in 9871⁄3 innings, Cain allowed 1,119 hits and 569 bases on balls, with 279 strikeouts.
His pitching career ended in the minor leagues in 1943, although he returned to the game to manage the Vidalia-Lyons Twins in the Class D Georgia State League for part of the 1948 campaign. He died in Atlanta on April 3, 1975, only two days before his 68th birthday.

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