Chapter 22: Cancer pain assessment and management
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Overview
The aim of this chapter is to present an overview of cancer pain, pain assessment and pain management.
Cancer pain is arguably one of the most common symptoms reported by cancer patients (Lang and Patt [120]). The prevalence of cancer pain has been estimated at 39.3% after curative treatment, 55.0% during anticancer treatment and 66.4% in advanced, metastatic or terminal disease (van den Beuken et al. [225]). Despite this high incidence of pain and advances in moderate treatment methods, up to 50% of patients continue to be undertreated (Deandrea et al. [50]) with 67% of patients reporting their experience of pain as distressing (Breivik et al. [20]). This high incidence of untreated pain results in a reduction in patient quality of life and can impact on the regular activities of daily living (Portenoy [174]).
Illustrations
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Figure 22.1
Processing of sensory input and motor output by the spinal cord. Source : Tortora and Derrickson ( ). Reproduced with permission from John Wiley & So...
Figure 22.4
TENS machine. Source : Dougherty and Lister ( ).
Figure 22.7
Points used to treat migraines/headaches. Source : Dougherty and Lister ( ).
Figure 22.10
Branches of a typical spinal nerve, shown in cross‐section through the thoracic portion of the spinal cord: transverse section. Source : Tortora and ...
Figure 22.13
Patient using Entonox demand valve. Source : The Royal Marsden.
Figure 22.2
The pain pathway showing key sites for particular analgesic interventions. NSAID, non‐steroidal anti‐inflammatory drug. Source : Dougherty and Lister...
Figure 22.5
A point used for acupuncture. Source : Dougherty and Lister ( ).
Figure 22.8
Acupuncture treatment record chart. Source : Adapted from BMAS ( ).
Figure 22.11
Distribution of dermatomes. Source : Tortora and Derrickson ( ). Reproduced with permission from John Wiley & Sons.
Figure 22.3
The WHO analgesic ladder. Source : World Health Organization ( ). Reproduced with permission of WHO.
Figure 22.6
A point used for pain relief. Source : Dougherty and Lister ( ).
Figure 22.9
Gross anatomy of the spinal cord. (a) Posterior view and transverse section through spinal cord. (b) Transverse section of the spinal cord within a ce...
Figure 22.12
Entonox cylinder and hose. Source : Dougherty and Lister ( ).