Pain Management in Advanced Cancer

My paper is regarding pain management in advanced cancer. As with all pain management for all diseases, there is room for much improvement even though this was identified as a priority in 2003 by the IOM. While there have been many research studies regarding pain management using both pharmacologic and nonpharmacologic methods, both healthcare providers and patients still exhibit barriers in the treatment of pain.

Of particular interest to us as nursing students are the recommendations to provide additional education to cancer patients regarding pain medications, side effects, alternative treatments. Adequate education by healthcare providers was one way to overcome patient barriers to pain control. One technique that was interesting was teaching patients to use a pain diary in order to monitor pain over the long-term disease process and to assist healthcare providers in assessing effective pharmacologic and nonpharmacologic treatments. Teaching healthcare providers to utilize standardized pain assessment tools and utilizing better protocols for reassessing pain following treatment were also recommended. The use of advanced practice nurses to train staff nurses in assessment and reassessment was also recommended. As many as 60-90% of cancer patients experience pain, so using EBP tools would greatly benefit their care.

While the typical use of OTC pain medications and opioid-based medications was mainly discussed along with the use of radiation and chemotherapy, I was disappointed that for the most part nonpharmacologic interventions were not shown to greatly improve pain outcomes. While many are effective in reducing pain, most are used as adjuncts to traditional pharmacologic measures.

Few of us may treat cancer patients, however, all of us will treat patients who are in pain. The use of better standardized tools and use of better reassessment techniques will greatly improve our care of not only cancer patients, but all of our patients.