Pain Management In The Cancer Patient

Pain management in the cancer patient

Cancer encompasses many diseases that are characterized by the development of abnormal cells that grow without adequate control in any organism location. Mass formation from these cells are called tumors, and their growth can destroy and replace normal surrounding tissues. This can be associated with pain;So much so that pain is one of the most frequent symptoms in cancer patients, presenting approximately 80-90% of this type of patients.

Pain management in cancer patients is vital, since both pharmacological and non -pharmacological treatments are applied, as will be displayed later in this work. It is relevant to point out the role of nursing in pain management in these patients, since they are a fundamental part of the assessment of the same and when providing the care that relieves it.

Pain assessment in the oncological patient

The proper assessment of pain in the oncological patient is a fundamental and essential phase to provide its proper treatment. This assessment allows us to evaluate the impact that pain causes on the patient and determining what effectiveness each of the different treatments that could be provided. The valuation of pain should be carried out at the time of diagnosis, but also throughout the evolution of the disease, since it can vary throughout the entire process and it is possible that it vary depending on many variables, which forces, in turn, to modify analgesic treatment over time.

For the nursing there is no single standardized method to perform this assessment, but that several methods that manage, together, six different dimensions of the patient: physiological, sensory, affective, cognitive, sociocultural and spiritual.

Among the different methodologies for pain assesspictorial or analog visual scales, of the most used, in which the patient indicates a point along a line depending on the pain that he experiences (see figure 1). The latter is highlighted by the Spanish Society of Medical Oncology, according to which it is possible.

Likewise, certain multidimensional scales also highlight, such as the McGill questionnaire, which quantifies four dimensions – sensory, affective, cognitive and behavioral – from the study of pain location, its intensity, its pattern, its quality and the factors that relieve itAnd they get worse.

Pharmacological and non -pharmacological treatments for pain management 

After the adequate assessment of the pain of the oncological patient, the best relief measure for it can be selected, depending on its characteristics. For this there are different types of treatments:

1. Pharmacological: The World Health Organization (WHO) has proposed an analgesic staircase based on the intensity of pain that establishes that non -opioid drugs must be selected first (paracetamol, non -steroid and adjuvant anti -inflammatories), to which opioides follow themweak (tramadol or codeine) and, finally, opioids (morphine, oxycodone, metadona, etc.).
2. Non -Pharmacological: They have therapies among which are radiotherapy, orthosis, radiofrequency ablation, palliative surgery, neurolative techniques, vertebroplasty or psychotherapy, among others. Each of them offers more or less benefits depending on the type of pain of each patient. Therefore, an adequate pain assessment is essential, in order to offer the most effective treatments will result in each patient.

The role of nursing is crucial throughout the entire process suffered by oncological patients. Regarding pain management in this type of patients, nursing has a fundamental role in its first and essential phase: the assessment of pain -by means of the methodologies already mentioned in this work-. Likewise, its role remains fundamental later, since the pain of the oncological patient is modified over time and it is essential to monitor it to continue measuring its possible changes (decrease or increase) to be able to offer the necessary measures and care to reduce it inThe measure of the possible. Precisely in this, in its treatment, nursing also has an important role, since it is the one who provides the necessary care to patients to mitigate their pain.

Pain assessment in the cancer patient is essential to offer the necessary care and treatments for its mitigation. It must be done in several spheres and there are different methodologies, among which those that involve the use of analog visual scales stand out.

The proper pain assessment is the one that allows the appropriate selection of the treatment, which can be pharmacological (non -opioids, weak opioids or opioids) or non -pharmacological (radiotherapy, psychotherapy, palliative surgery, etc.). Its proper selection is fundamental when mitigating as much as possible the pain of cancer patients. Nursing has a fundamental role in the management of the pain of the oncological patient since it participates from the beginning -its assessment -as well as during the process -monitoring through frequent valuations -and its treatment with the application of the most appropriate measures.

Bibliography

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3. Dopicosantamariña LM, Hermida Porto L. Oncological pain management [Internet monograph]. Fisterra;2014 [access January 8, 2018]. Retrieved on 10/9/2019 at: http: // www.Fisterra.com/guides-clinics/management-pain-oncological/