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Information for Nurses and Physicians
Cancer Pain Management
Scope of the Problem
Each year, over one million
Americans are diagnosed with cancer. About
8 million Americans now have cancer or a
history of cancer. Cancer causes 1 in every
10 deaths world-wide. Cancer pain is frequently
undertreated. Thirty to forty-five percent
of patients experience moderate to sever
pain. In approximately 90% of patients,
cancer pain can be controlled through relatively
simple means. This article will examine
the importance of controlling pain, patients'
perspectives of pain, effects of cancer
pain, and where to start the fight against
cancer pain.
Importance of Controlling
Pain
Pain control deserves high
priority for two reasons. First, unrelieved
pain causes unnecessary suffering. Second,
even when then underlying disease is stable,
uncontrolled pain prevents patients from
working productively, functioning in daily
life, enjoying recreation, or taking pleasure
in their life. Assessment and treatment of
pain in the cancer patient is imperative
for all healthcare professionals because
failure to do so can lead to the undertreatment
of pain. Clinical settings administering
cancer care should implement a program of
pain management. Within each institution,
evaluating pain management and obtaining
feedback is an important component to delivering
the most effective cancer pain management.
The quality of cancer pain management should
be evaluated at points of transition (e.g.
from hospital to home) to maintain optimal
management.
Specific actions are necessary
to ensure effective communication among
the health care professionals. These include
clarity among professionals, effective decision-making,
contingency planning, and interdisciplinary
meetings if possible. Communication between
physicians and patients must also be improved.
Patients' Perspectives
One of the worst aspects
of cancer pain is that it's a constant
reminder of the disease and death. Many
fear the pain will become unbearable before
death, and those of us involved in support
networks have seen these fears proven
true... My dream is for a medication that
can relieve my pain while leaving me alert
and with no side effects.
-- Jean Stover, co-founder of Living Through
Cancer
Effects of Cancer Pain
- Physical: decreased functional
capability, diminished strength, endurance,
nausea, poor appetite, poor or interrupted
sleep.
- Psychological: diminished leisure
time, enjoyment, increased anxiety, fear,
difficulty concentrating, somatic preoccupation,
loss of control.
- Social: diminished social relationships,
decreased sexual function, altered appearance
- Spiritual: increased suffering,
altered meaning, reevaluation of religious
beliefs
Where to Start
The first step in effective
pain management in the cancer patient
is understanding of these concepts and
their effects on the patient. Second,
physicians must learn to help patients
report their pain accurately. Once this
understanding is established, effective
methods to combat pain can be implemented.
Cancer pain is a problem of international
scope and the World Health Organization
has urged that every nation give high
priority to establishing a cancer pain
relief policy.
Source:
Clinical Practice Guideline #9: Management
of Cancer Pain. (1994). U.S.
Department of Health and Human Services.
(Submitted
by Amy Kley, Research Assistant)
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