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Flashcards in Pain Management Deck (113)
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1

Is cancer pain a manageable concern?

Yes, in most cases

2

What % of cancer pain can be relieved relatively simply, with oral analgesics and adjuvant drugs?

80-90%

3

What is the problem with inadequate pain control in cancer?

It may exacerbate other problems

4

What other problems might be exacerbated by inadequate pain control in cancer?

- Fatigue
- Nausea
- Constipation
- Depression

5

Why might pain affect compliance in cancer?

It is more difficult for a patient in pain to continue with demanding cytotoxic treatments and hospital visits

6

What should be done when a patient presents with cancer pain?

A careful history should be taken to identify any reversible or remediable causes of the patient's pain

7

What might cancer pain derive from?

- Tumour progression and related pathology
- Procedural intervention
- Treatment toxicity
- Infection
- MSK issues

8

Specifically, what are the most common causes of pain in cancer patients?

- Peripheral neuropathies secondary to chemotherapy or tumour invasion
- Tissue injury secondary to radiotherapy
- Chronic post-surgical incisional pain
- Bone metastases
- Visceral pain

9

What can aggravate cancer pain?

- Other physical symptoms
- Psychological symptoms
- Social factors
- Spiritual or existential suffering
- Medical crisis

10

What other physical symptoms can exacerbate cancer pain?

- Insomnia
- Loss of appetite
- Fatigue

11

What psychological symptoms can exacerbate cancer pain?

- Distress
- Anxiety
- Depression

12

What happens even though cancer pain is manageable?

It is often undertreated

this card is bit dodgy sorry lol

13

What medical failures most commonly contribute to uncontrolled cancer pain?

- Inadequate assessment
- Failure to detect general distress
- Lack of systemic approach to analgesia
- Lack of knowledge of opioid pharmacology

14

How can inadequate assessment lead to uncontrolled cancer pain?

Can result in misdiagnosis of the cause and type of pain

15

How can failure to detect general distress lead to uncontrolled cancer pain?

Lowers pain threshold


??? lol

16

Give an example of when lack of knowledge of opiate prescribing can lead to uncontrolled cancer pain

Failure to anticipate and prevent side effects

17

Why is it important to understand the patient's pain in cancer

Because treatment must be tailored for the individual, according to the nature, likely mechanisms, and subjective component of pain

18

Is a diagnosis of cancer a sufficient explanation for the patient feeling pain?

No

19

What is the result of a diagnosis of cancer being an insufficient explanation for the patient experiencing pain?

You need to determine what is the actual cause

20

What might pain of a sudden onset suggest in cancer?

- Acute complication of the malignancy
- Unrelated cause, e.g. new pathological fracture, mucositis due to radiotherapy

21

What might chronic escalating pain be caused by in cancer?

Underlying disease progression, e.g. soft tissue or nerve root infiltration

22

What are the different natures of pain?

- Somatic
- Visceral
- Neuropathic

23

What are the characteristics of somatic pain?

Typically localised and persistent

24

Give 2 examples of causes of somatic pain in cancer

- Bone metastases
- Localised inflammation such as cellulitis

25

What are the characteristics of visceral pain?

Usually poorly localised, of variable intensity, and often occurring with associated symptoms such as nausea

26

Give 2 examples of causes of visceral pain in cancer

- Hepatic metastases
- Malignant abdominal lymphadenopathy

27

What are the characteristics of neuropathic pain?

- Classically described as 'shooting pain' or 'burning'
- Usually follows a nerve distribution
- Typically less responsive to opiate therapy

28

Give an example of a cause of neuropathic pain in cancer

Compression of spinal nerve root

29

What is the result of pain having a strong affective component?

It is greatly influenced by mood and morale

30

Why is it important to consider the affective component of pain when managing it?

An understanding of the patient's perception of pain will help formulate an effective management plan