Assessment of cancer pain
- Russell K Portenoy, MD
Russell K Portenoy, MD
- Chief Medical Officer
- MJHS Hospice and Palliative Care
- Professor of Neurology and Family and Social Medicine
- Albert Einstein College of Medicine
- Lara K Dhingra, PhD
Lara K Dhingra, PhD
- Assistant Professor of Neurology and Psychiatry and Behavioral Sciences
- Albert Einstein College of Medicine
Pain due to cancer is a complex symptom that affects most aspects of a person's life, including physical functioning, the performance of activities of daily living, psychological and emotional status, and social interactions.
The prevalence of pain among cancer patients varies widely and is influenced by numerous factors, including the population evaluated, the specific type of cancer and its extent, and the treatment setting [1,2]. The estimated prevalence of chronic pain in populations undergoing cancer treatment ranges from 33 to 59 percent, and it is considerably higher (64 to 74 percent) in patients with advanced disease [1,2].
Given the high prevalence of cancer pain and its potential for profound adverse consequences, all patients with active malignancy should be routinely screened for pain. Patients who report pain require a more comprehensive assessment and specific treatment.
This topic review will cover cancer pain assessment. Classification of the different syndromes of pain in cancer patients and treatment of cancer-related pain are addressed elsewhere. (See "Overview of cancer pain syndromes".)
CANCER PAIN ASSESSMENT
Cancer pain assessment is a complex undertaking. The evaluation begins with a thorough history of both the pain and the underlying malignancy as well as its treatment. Because of the potential impact of pain on quality of life, it is also essential to determine the adverse effects of pain on physical and psychosocial wellbeing, as well as the spiritual impact of the pain. Cancer pain may linger after the cancer is removed (as examples, post mastectomy, post amputation or post thoracotomy syndrome), and this may have important psychological and spiritual impact . (See "Overview of cancer pain syndromes", section on 'Postsurgical pain syndromes'.)
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