Today, there is no reason that cancer pain should go untreated or ignored. Advancements in treatment now offer a wide variety of options for pain relief. If left unattended, cancer pain can lead to disruption in patients' ability to work, their interpersonal relationships, and their view of the world. Above all, under and untreated cancer pain can lead to unnecessary suffering and despair.
* Causes of cancer pain
* Assessment of cancer pain
* Treatment of cancer pain
* Side - effects of pain treatment
* Since taking your pain medication
* Communicating about pain
* Myths and misconceptions
CAUSES OF PAIN
Cancer pain can have multiple causes. However, it is not necessary to pinpoint the exact cause before you begin treating it. These are some common causes to bear in mind during assessment and treatment:
* Is the patient's pain caused by a tumor pressing on bone, nerves or body organs?
* Is the pain from recent chemotherapy,radiation, surgery or some other medical procedure?
* Is the pain from unrelated causes such as headaches, muscle strain and arthritis?
ASSESSEMENT OF PAIN
Before you proceed with a treatment plan, the patient's pain should be thoroughly assessed. To be comprehensive, you should complete a physical and psychosocial evaluation and take a thorough history of the pain. Here are some key points to cover:
* What activities make the pain feel worse ? Better?
* Has the patient taken any steps to alleviate the pain?
* Is the patient anxious and depressed about the pain?
* Has the patient had previous experiences with pain?
* Has the patient developed a theory about the cause of the pain?
* Does the pain disrupt sleep, work, mood or concentration?
To get a reading of the pain intensity, use the following visual analog scale (VAS) at every patient meeting:
0 1 2 3 4 5 6 7 8 9 10
0 means no pain whilst 10 is ranked as pain as bad as you can imagine
TREATMENT
Medication is the mainstay of treatment for cancer pain. In order to achieve optimal results, a physician with experience in treating pain should be involved in the treatment plan.
These principles should be applied:
* each regimen must be tailored to the individual patient
* the least invasive therapies should be tried first
* if pain increases or persists an opioid may needed
* medication is best administered around-the-clock
Medication is the mainstay of treatment for cancer pain
SINCE TAKING YOUR PAIN MEDICATION
* Have you experienced constipation?
* Have you experienced nausea and vomiting?
* Have you felt sleepy when you wanted to stay awake?
* Have you experienced difficulty breathing?
Side effects
If the patient is on pain medication, ask the patient about these common side-effects, Remember, it is best to treat side-effects early on.
Remember -- people have the right to have their pain believed and relieved. Pain management is an ongoing process that requires continuous re-assessment and re-adjustment. If at first you don't succeed in bringing about pain relief for the patient, try new drugs, new combinations and additional, non-pharmacologic techniques.
myths
These common misconceptions may prevent frank communication about pain or lead to non-compliance. Patients may be reluctant to verbalize these concerns unless you raise them:
* Does the patient or family fear addiction to pain medication?
* Does the patient or family believe that talk of pain will distract the physician from treatment?
* Does the patient or family believe that living with pain shows strength?
COMMUNICATING ABOUT PAIN
Communicating about pain with your patients is essential, both for accurate assessment and treatment compliance. You will get optimal treatment results if you implement a plan based on the patient's self-report. Its best to see yourself and the patient as a working team.
* Ask the patient about pain
* Encourage the patient to keep a pain diary
* Recommend that the patient write out questions for you
* Invite a family member to participate in meetings
* Inquire about the patient's medical insurance coverage and financial concerns