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Cancer Breakthrough Pain in the Presence of Cancer-Related Chronic Pain: Fact versus Perceptions of Health-Care Providers and Patients

Publish date: January 25, 2011

 

Table 2. Methods of Pain Assessment
ASSESSMENT
Unidimensional scalesNumerical Rating Scale (NRS)
Visual Analogue Scale (VAS)
Verbal Rating Scale
Wong Baker FACES Pain Rating Scale
Colored Visual Analogue Scale
Coping Strategies Questionnaire
Multidimensional scalesBrief Pain Inventory
McGill Pain Questionnaire

Pain assessments may be unidimensional or multidimensional. Unidimensional assessments such as the Visual Analogue Scale and the Numerical Rating Scale60 offer simple measurements for changes in pain intensity,61 are easy to use, and require minimal health-care provider involvement. Multidimensional pain assessment instruments like the Brief Pain Inventory and the McGill Pain Questionnaire, on the other hand, consider not only pain intensity but also dimensions such as changes or fluctuations in pain, treatments, location of pain, physical descriptions of pain sensations, emotions and feelings related to pain, duration of pain, and history of pain.61

An additional resource to utilize would be the pain knowledge of nurses. Performance-based testing to examine the deficiencies in assessment and management of cancer show that hospice-care nurses were more proficient in assessing pain intensity and pain location than resident and family physicians.[62], [63] and [64] Nurses also have the opportunity to spend more time with the patient and to assess response to treatment plans.56

Conclusions

Cancer BTP is underdiagnosed and undertreated due to a number of patient and health-care provider–related factors. By identifying misconceptions; providing education to health-care providers, patients, and family caregivers; and accessing all available resources to improve pain diagnosis and management, steps can be taken to ensure that patients experiencing persistent cancer pain and cancer BTP are properly treated.

Acknowledgments

Funding for the preparation of this article was provided by Meda Pharmaceuticals, Inc. Editorial support was provided by M. K. Grandison, PhD, of inScience Communications, a part of the Wolters Kluwer organization.

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