Article by Pharmacy Times

“Pain is a common symptom among patients with cancer, with the most recent literature suggesting that 64% of patients with advanced or metastatic cancer report pain. Although report results suggest that adequate pain control may be achieved in up to 90% of patients, less success is achieved in clinical practice.

Cancer Pain Assessment
Adequate pain assessments are an integral component of cancer pain management. Initial and subsequent assessments of cancer pain at each point of patient contact are critical to optimizing outcomes and patient quality of life. During each assessment, clinicians should have patients use validated scales to self-quantify their pain intensity for their “current,” “worst,” “average,” and “least” pain over the past 24 hours.

Based on the patients’ reports, their pain should be classified as mild (1-3), mild-moderate (4-6), and moderate-severe (7-10). In addition to pain intensity, ask patients to describe the history and quality of pain (ie, aching vs sharp vs throbbing pain, onset, pain at rest vs pain at movement, and treatment regimen) to aid in classifying the type of pain. Cancer pain can be generally divided into 2 categories: neuropathic pain, which is caused by damage to the nervous system, and nociceptive pain, which is caused by ongoing tissue damage. The response to treatment regimen and severity and type of pain determine future treatment modalities for each patient.

In patients who are unable to self-report their pain quality or severity, because of cognitive or psychological deficits, pain can be assessed through a behavioral pain scale to assess behavioral changes, body movements, facial expressions, and the patient’s level of discomfort.”

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