Definition of Pain
Pain is “an unpleasant sensory and emotional experience associated with actual or potential tissue damage” (IASP Subcommittee on Taxonomy, p. 250). What this tells us is that pain is far more than a physical phenomenon; it clearly has a sensory and emotional component. A very important definition of pain is: “Pain is whatever the experiencing person says it is, existing whenever he/she says it does” (McCaffery, p. 95). This is important in that it is critical to always believe the patient with cancer who says that he/she has pain
Pain terms: a list with definitions and notes on usage. Recommended by the IASP Subcommittee on Taxonomy. Pain 1979;6:249–252
McCaffery M. Nursing Practice theories related to cognition, bodily pain, and man–environment interactions. Los Angeles, UCLA Student Store, 1968
More than 70% of patients with advanced cancer report having moderate-to-severe pain
At time of diagnosis and during active treatment, 30–50% of patients have cancer pain
In the advanced stages, 70–90% have pain (Levy)
40–50% of patients report their pain as being moderate or severe
25–30% of patients report very severe or excruciating pain
In a large series of 2000 patients, one-third had 1 site of pain, one-third had 2 sites of pain, and one-third had 3 or more sites (Twycross)
Levy MH. N Engl J Med 1996;335:1124–1132
Twycross R. In: Sykes N, Fallon MT, Patt RP, eds. Clinical Pain Management: Cancer Pain/Practical Applications & Procedures. London, UK: Hodder & Stoughton Educational; 2003:3–21
Table 52–1.Etiology of Cancer Pain |Favorite Table|Download (.pdf) Table 52–1. Etiology of Cancer Pain
Pain secondary to tumor involvement
Invasion into cutaneous, deep tissues and bone, resulting in somatic pain:
Injury to sympathetically innervated organs, resulting in visceral pain:
Hepatic distention syndrome
Midline retroperitoneal syndrome
Chronic intestinal obstruction
Malignant perineal pain
Adrenal pain syndrome
Aberrant somatosensory processes caused by injury to nervous system, resulting in neuropathic pain:
Pain after diagnostic and therapeutic procedures
Surgical removal of tumor or metastases:
Arthralgia and myalgia caused by paclitaxel
Hand/foot syndrome (capecitabine)
Flare of bone pain with hormonal therapy for breast and prostate cancer
Portenoy RK, Conn M. Cancer pain syndromes. In: Bruera ED, Portenoy RK, eds. Cancer Pain: Assessment and Management. New York, NY: Cambridge University Press; 2003:89–108
McGuire DB. Occurrence of cancer pain. J Natl Cancer Inst Monogr 2004;32:51–56
Table 52–2.Physical Pain Assessment
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