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INTRODUCTION

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

Prevalence

  • 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
Table 52–2.Physical Pain Assessment

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