Overview
Clinical Orientation
Pain from cancer is not simply a number to lower.
Pain from cancer is not simply a number to lower. Bone, visceral, neuropathic, treatment-related, and psychological contributors can coexist; the pattern, functional effect, and trajectory matter as much as intensity. A patient with burning foot pain after chemotherapy needs a different adjunct from one with movement-related vertebral pain, even if both report 6/10. Use the Edmonton Symptom Assessment System, revised (ESAS-r), to screen and grade cancer-related pain: 1-3 is mild, 4-6 is moderate, and 7-10 is severe. Pair the score with location, quality, timing, triggers, and effects on sleep or movement. A new severe score, sudden change, or pain accompanied by neurologic findings may signal a complication rather than a routine need for more analgesic. The practical nurse's clinical model has two parts: relieve pain with scheduled multimodal treatment and prescribed breakthrough medication while checking whether treatment is causing harm. Reassess response, sedation, respirations, bowel function, and renal considerations; report uncontrolled pain or red flags promptly.
