Chapter 22: Cancer pain assessment and management
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Acute pain
The IASP has defined acute pain as: ‘Pain of recent onset and probable limited duration. It usually has an identifiable temporal and causal relationship to injury or disease’ (Ready and Edwards [183], p.1). Acute pain is produced by a wide range of physiological processes, and includes inflammatory, neuropathic, sympathetically maintained, visceral and cancer pain (Walker et al. [228]). Acute pain serves a purpose by alerting the individual to a problem and acting as a warning of actual or potential tissue damage. Pain may be the presenting symptom that causes patients to seek healthcare review leading to their subsequent cancer diagnosis. If left untreated, acute pain may result in severe consequences; for example, not seeking help for acute abdominal pain may result in an emergency such as bowel obstruction. Acute pain occurs in response to any type of injury to the body and resolves when the injury heals.
Common causes of acute pain in patients with cancer include:
- diagnostic interventions (e.g. biopsy, lumbar puncture, repeated venepuncture, wound care, endoscopy)
- therapeutic interventions (e.g. surgery, tumour embolization, catheterization)
- anticancer treatments (e.g. chemotherapy, radiotherapy, surgery)
- infection and/or vascular events (e.g. venous thromboembolism, cellulitis)
- acute tumour‐related pain (e.g. pathological fractures, vertebral collapse, ureteric obstruction, bowel obstruction).
