Pain Associated With Malignancy (Chronic Malignant Pain)
Chronic malignant pain can have a combination of acute, intermittent, or constant components. Although the pain is chronic, it can have elements of acute pain when tissue damage continues from tumor infiltration. Nerve destruction, chemotherapy, radiation therapy, and surgery also contribute to malignant pain. Occasionally, chronic malignant pain has only minimal or no associated objective clinical physical findings, and may be erroneously dismissed by inexperienced clinicians.
Anticipation by the patient that malignant pain will be continuous leads to anxiety, depression, and insomnia.26 These destructive feelings can accentuate the patient's perception of pain. Inadequately treated chronic malignant pain can become progressively more severe and cause relentless suffering. Persistent pain can accelerate the deterioration of the patient's physical and psychological condition more than the malignancy itself.
The most important aspect of chronic malignant pain management is a logical and systematic approach with the goal of pain alleviation (or minimization) and prevention. A primary element of this approach is patient access to health care and pain management information. It is the duty of all health care providers to effectively assess their patients' pain management needs and to make appropriate referrals or therapeutic changes.
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