Pain

Pain

At the time of diagnosis, 20%–75% of patients with cancer report having pain. Pain can be categorized as acute, chronic, breakthrough, or refractory and is caused by injury to body tissues (nociceptive) or damage to the peripheral or central nervous system (neuropathic).

Pain may be caused by the cancer, diagnostic procedures, cancer treatment, or pre-existing conditions. Neuropathic pain is associated with surgical procedures, such as radical neck dissection, mastectomy, thoracotomy, nephrectomy, and limb amputation, and with chemotherapy, including vinca alkaloids, taxanes, platinum compounds, and thalidomide (see the peripheral neuropathy PEP resources).

Acute pain is typically related to diagnostic procedures and cancer treatment and is generally defined as lasting no longer than three months. The most common types of acute pain related to cancer treatment are postoperative pain and the pain of oral mucositis. The acute pain of some patients with cancer may be caused by arthralgia or myalgia, which can be side effects of some chemotherapy drugs and biologic therapy.

Have a question about how to apply this PEP topic to your practice? Ask a nurse on ONS staff at clinical@ons.org

Breakthrough pain is sudden, brief pain that occurs during a period when chronic pain is generally well controlled (typically, controlled with opiods). Breakthrough pain may happen when the patient is at rest or be related to activity or a change of position.

Have a question about how to apply this PEP topic to your practice? Ask a nurse on ONS staff at clinical@ons.org

Chronic pain persists three months or more. The most frequent cause of cancer-related chronic pain is bone metastasis. Chronic pain may also be a result of cancer treatment, including surgery, chemotherapy, and radiation therapy.

Have a question about how to apply this PEP topic to your practice? Ask a nurse on ONS staff at clinical@ons.org.

Intractable pain or refractory pain occurs when pain cannot be adequately controlled despite aggressive measures.

Have a question about how to apply this PEP topic to your practice? Ask a nurse on ONS staff at clinical@ons.org

2011–2015 Authors

Christine A. Miaskowski, RN, PhD, FAAN, Jeannine M. Brant, PhD, APRN, AOCN®, Pamela Caldwell,  RN-BC, MS, OCN®, Linda Eaton, PhD, RN, AOCN®, Eva Gallagher, RN, PhD, Natalie Gallagher RN, MPH, OCN®, Zehra Habib, RN, BSN, Josie Howard-Ruben, MS, RN, APN-CNS, AOCN®, Sharon S. Kilbride, RN, BSN, OCN®, Lynne M. Kuhl, RN, Dawn M. Kunz, RN, MSN, AOCN®, CHPN, Karen McLeod, MSN, RN, OCN®, CNL, Barbara Rogers, CRNP, MN, AOCN®, ANP-BC, Wendy J. Smith, RN, MSN, ACNP, AOCN®, Malgorzata Sokolowski, MSN, APN, OCN®, AOCNS®, Evie Sprague, MSN, RN, OCN®, CCRP, Bethany Sterling, MSN, CRNP, OCN®, CHPN, Julie A. Summers, RN, BSN, OCN®, Mary Lou Sylwestrak, RN, MS, OCN®, CWOCN, Linda M. Truty, RN, Fabienne G. Ulysse, DNP, RN, MSN, ANP, AOCNP®, Kimberly L. Valochovic, APN, MSN, AOCNS®, and Karen L. Visich, MSN, ANP-BC, AOCNP®

ONS Staff: Margaret M. Irwin, PhD, RN, MN, Christine M. Maloney, BA, Kerri A. Moriarty, MLS, and Mark Vrabel, MLS, AHIP, ELS

 

2009 Authors

Lisa B. Aiello-Laws, RN, MSN, APNG, AOCNS®, and Suzanne W. Ameringer, PhD, RN

Research Consultants: Marie A. Bakitas, RN, DNSc, ARNP, AOCN®, FAAN, and Christine Miaskowski, RN, PhD, FAAN

ONS Staff: Linda H. Eaton, MN, RN, AOCN®

 

2007 Authors

Lisa B. Aiello-Laws, RN, MSN, APNG, AOCNS®, Nancy A. Delzer, MSN, RN, AOCN®, BC-PCM, Mary E. Peterson, RN, OCN®, and Janice K. Reynolds, RN, BSN, OCN®

ONS Staff: Kristine B. LeFebvre, MSN, RN, AOCN®


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