Cancer Pain: Part 1: Pathophysiology; Oncological, Pharmacological, and Psychological Treatments: A Perspective from the British Pain Society Endorsed by the UK Association of Palliative Medicine and the Royal College of General Practitioners

Abstract

It is recognized that the World Health Organization (WHO) analgesic ladder, while providing relief of cancer pain towards the end of life for many sufferers worldwide, may have limitations in the context of longer survival and increasing disease complexity. To complement this, it is suggested that a more comprehensive model of managing cancer pain is needed that is mechanism-based and multimodal, using combination therapies including interventions where appropriate, tailored to the needs of an individual, with the aim to optimize pain relief with minimization of adverse effects.

Mindfulness, cancer, and pain

“…Cancer pain is complex, and may involve compressive, inflammatory, ischemic, and neuropathic mechanisms occurring at many regions. 3 While biological and neuropathic pain etiologies are common in cancer, cognitive and affective aspects of cancer pain can more strongly contribute to pain ratings than sensory aspects. 4 Psychological factors such as a patient's pain castrophizing, 5 mental adjustment to cancer, 6 and pain anxiety 7 may affect the subjective pain experience.…”

Self-Esteem, Pain and Suicidal Thoughts in a Sample of Cancer Patients

“…Women with gynecological cancer had poorer body image and lower self-esteem than healthy women (16). Self-esteem of cervical cancer survivors has been shown to be affected by the cancer and its treatment due to changes in their bodies, self-image, and relationships especially changes in the uterus, ovaries, vagina, and vulva, which are associated with femininity, sexuality, and fertility Pain in cancer patients may lead to avoiding from rewarding and enjoyable activities which in turn may result in loss of self-esteem (34). In our study, half of the sample suffered pain at the assessment period.…”

Using Numbers Creates Value for Health Professionals: A Quantitative Study of Pain Management in Palliative Care

“…However, there is a risk of misconception regarding documentation by numbers due to the nature of pain. As other researchers point out [32][33][34], numbers are not enough; documentation needs to be complemented with pain localization, character of pain, etc. to understand and provide optimal treatment.…”

“…It is also somatic, visceral, or neuropathic in nature [16]. Pain is a subjective experience, which is why optimal selection of pain management requires a detailed analysis and flexible use of methods and skills from an interdisciplinary team [32][33][34]. There is also need for a care system that can identify, initiate, and monitor treatment to achieve optimal pain management [35].…”