- The assessment of pain is part of the holistic care of the patient
- 30% of people with cancer have no pain and those with pain often have several types.
- Cancer pain may also be related to debility e.g. pressure ulcers.
- A patient who feels cared for may feel less pain and a patient free from pain is better placed to face his/her illness. 95% of pain in cancer can be well controlled.
- Patient and carer understanding of the use of their medication is vitally important in achieving good pain control.
Four types of cancer related pain
Visceral/soft tissue pain
– Opioid sensitive – use the “ladder” see Section: Analgesic Medication
Bone pain
– Maybe NSAID sensitive.
– Partly opioid sensitive.
– Radiotherapy may help.
Nerve related
– Partly opioid sensitive.
– Adjuvant analgesics may often be needed.
Incident pain
This is a specific type of breakthrough pain related to a particular activity, e.g. micturition, wound dressing changes or movement.
Other considerations
Many pains are not cancer related but may be:
– Treatment related e.g. constipation, post radiotherapy.
– Coincident illness or condition e.g. arthritis, migraine.
Many factors influence the perception of pain. e.g. fear, loneliness, boredom.
If the patient’s pain appears not to respond, consider alternative causes of pain (spiritual, social or psychological factors).