Pain is a frequent symptom in the evolution of cancer, affecting 70% of patients throughout the course of the disease and producing a considerable decrease in functionality and quality of life.
Its characteristics can vary depending on the structures and mechanisms involved in its appearance, often acquiring a chronic character as a consequence of the progression of the disease and the measures used to slow its evolution. Pharmacological treatment should be adapted to the type and intensity of the pain and judicious and early use should be made of interventional techniques and radiotherapy in those cases in which it is indicated, in order to optimize analgesic control and minimize side effects.
It is usually associated with the etiological treatment causing the process and accompanied by a comprehensive assessment of the patient, including the social and psychological environment.
One of the main factors involved in its high incidence is the lack of identification of it, being perceived by patients as something inherent to the disease and with less importance for the clinician than other more physical or tangible symptoms. The fear of drug dependence, of developing tolerance, and of their ineffectiveness if the pain worsens, or of it being a sign of disease progression are some of the fears that lead the patient not to report the existence of pain.
Pain has a marked impact on the patient’s functional and psychological state, resulting in a worsening of quality of life and personal relationships, as well as anxiety, depression, and sleep disorders. It is necessary to adopt adequate analgesic treatments and the development of coping maneuvers to prevent the patient from falling into catastrophism and to take an active role in pain management.
It is therefore essential that the medical-surgical team and the nurse in charge of the patient maintain a constant assessment of the patient’s level of comfort and be alert to indirect signs of the presence of pain.
Among the causes of pain are both the organic involvement of the disease itself, as well as its progression with the infiltration of adjacent or distant tissues, as in the case of metastases.
Pain can present itself in very different locations and forms depending on the mechanism involved. Thus we can distinguish between these patients:
NOCICEPTIVE PAIN: caused by tissue injury. It can be divided into:
- Somatic: caused by bone, joint, or muscle lesions, frequently due to metastatic lesions. It is described as a sharp and well-localized pain.
- Visceral: caused by invasion of abdominal or pelvic organs. It manifests as diffuse, oppressive, and poorly localized pain. It can be referred to as a distant cutaneous area that has the same innervation.
NEUROPATHIC PAIN: due to peripheral or central nerve lesion by compression, section, hemorrhage, chemical mechanisms, etc. It causes burning pain, with the sensation of electricity, hypoesthesia, or dysesthesia. It may appear as a complication after surgery, radiotherapy, or chemotherapy, as well as due to the involvement of the lumbosacral plexus. For more help, tips, and advice about chronic pain treatment, you may visit their page for more info.
PSYCHOLOGICAL PAIN: pain is mediated mainly by psychological factors. It is rare in patients affected by cancer and should be a diagnosis of exclusion once other causes of pain have been ruled out.
