Chapter 22: Cancer pain assessment and management
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Persistent or chronic pain
Chronic pain is usually prolonged. It is defined as pain that exists for more than 3 months, lasting beyond the usual course of the acute disease or expected time of healing (IASP [107]). It is often associated with major changes in personality, lifestyle and functional ability (Orenius et al. [161]). Chronic pain in patients with cancer may also worsen or intensify with time depending on the status of the underlying disease. Chronic or persistent cancer pain syndromes can be associated with direct tumour invasion or cancer therapy (Chapman [35]).
Types of chronic cancer‐ or cancer‐treatment‐related pain include the following:
- tumour‐related pain – direct infiltration, compression, distension or stretching, e.g. pancreatic cancer or liver capsule pain
- bone metastases or skeletal muscle tumours
- neuropathic pain from infiltration of the tumour into peripheral nerves, nerve plexuses and spinal cord
- chemotherapy‐induced peripheral neuropathy
- chronic pain after surgery syndromes (e.g. thoracotomy pain, post‐mastectomy pain syndrome, phantom limb pain)
- pain in cancer survivors.
