Patient Self-Report
Assessment of the Outcomes of Pain Management

To treat pain, it must be measured. The patient and the doctor should measure pain levels at regular intervals after starting cancer treatment, at each new report of pain, and after starting any type of treatment for pain. The cause of the pain must be identified and treated promptly.

To help the health care provider determine the type and extent of the pain, cancer patients can describe the location and intensity of their pain, any aggravating or relieving factors, and their goals for pain control. The family/caregiver may be asked to report for a patient who has a communication problem involving speech, language, or a thinking impairment. The health care provider should help the patient describe the following:

• Pain: The patient describes the pain, when it started, how long it lasts, and whether it is worse during certain times of the day or night.



• Location: The patient shows exactly where the pain is on his or her body or on a drawing of a body and where the pain goes if it travels.



• Intensity or severity: The patient keeps a diary of the degree or severity of pain.



• Aggravating and relieving factors: The patient identifies factors that increase or decrease the pain. The patient also identifies symptoms that are most troublesome, since they are not always the most serious or severe.



• Personal response to pain: Feelings of fear, confusion, or hopelessness about cancer, its prognosis, and the causes of pain can affect how a patient responds to and describes the pain. For example, a patient who thinks pain is caused by cancer spreading may report more severe pain or more disability from the pain.



• Behavioral response to pain: The health care provider and/or caregivers note behaviors that may suggest pain in patients who have communication problems.



• Goals for pain control: With the health care provider, the patient decides how much pain he or she can tolerate and how much improvement he or she may achieve. The patient uses a daily pain diary to increase awareness of pain, gain a sense of control of the pain, and receive guidance from health care providers on ways to manage the pain.

The results of pain management should be measured by monitoring for a decrease in the severity of pain and improvement in thinking ability, emotional well-being, and social functioning. The results of taking pain medication should also be monitored. Drug addiction is rare in cancer patients. Developing a higher tolerance for a drug and becoming physically dependent on the drug for pain relief does not mean that the patient is addicted. Patients should take pain medication as prescribed by the doctor. Patients who have a history of drug abuse may tolerate higher doses of medication to control pain.

Glossary Terms

Uncontrollable craving, seeking, and use of a substance such as a drug or alcohol.

A term for diseases in which abnormal cells divide without control. Cancer cells can invade nearby tissues and can spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord.

A mental state in which one is not thinking clearly.

The amount of medicine taken, or radiation given, at one time.

Any substance, other than food, that is used to prevent, diagnose, treat or relieve symptoms of a disease or abnormal condition. Also refers to a substance that alters mood or body function, or that can be habit-forming or addictive, especially a narcotic.

The use of illegal drugs or the use of prescription or over-the-counter drugs for purposes other than those for which they are meant to be used, or in large amounts. Drug abuse may lead to social, physical, emotional, and job-related problems.

A condition that occurs when the body gets used to a medicine so that either more medicine is needed or different medicine is needed.

A loss of part or all of a physical or mental ability, such as the ability to see, walk, or learn.

A legal drug that is used to prevent, treat, or relieve symptoms of a disease or abnormal condition.

In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).

A doctor's order for medicine or another intervention.

The likely outcome or course of a disease; the chance of recovery or recurrence.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.