Cancer is a grave disease that is highly lethal and often delivers a slow and painful death at later stages. Cancer is estimated to reveal itself in as many as 100 types. Statistically, in 2008 the mortality rate from cancer was at the level of 62% (Siegel, Ma, Zou, & Jemal, 2014). Global prevalence of various types of cancer in 2008 constituted 12.7 million (Siegel et al., 2014). Since the cases are so frequent and pain is present in most of them, there is a necessity for intervention that will help increase the quality of life at later stages of the disease development.
Definition
Cancer is an umbrella term for more than one hundred types of diseases that all share common pattern of growth and multiplication of malignant cells in tissues and organs. As the disease progresses, tumors form, which at later stages transfer their cells into other parts of the body developing other tumors (Siegel et al., 2014). In juxtaposition with benign tumors, malignant ones are highly dangerous and often lethal if no timely intervention is effected.
Epidemiology
Across the US there was 1,660, 290 documented cases of cancer in 2014 (Siegel et al., 2014). In a more recent study that tracked the incidence of pain based on self-reported data, it was estimated that mild to severe pain persisted in 64% cases. Even though the knowledge of extreme pain during the late stages is almost universal among professionals, according to recent surveys, around 30% of doctors do not refer their cancer patients to pain specialists (Siegel et al., 2014). That is one of the prime reasons for selection of education on pain management as an intervention for study.
Clinical Presentation
Symptoms vary across the cancer population depending on the type of cancer and the stage of its progression. The most common types of pain include Nociceptive, Viceral, Neuropathic or Incidental pain (Smith & Saiki, 2015). The pain is often associated with nerve pressure, damage to nervous system done by cancer cells or treatment, bone or organ tissue damage dealt by cancer cells or treatment (Smith & Saiki, 2015).
Complications
Pain that is associated with movement often diverts patients from any activity that triggers pain and due to that fact, the comfort and quality of life are undermined (Smith & Saiki, 2015). The milder cases of pain can distract people from their activities. Complications may also arise from pain therapy such as narcotic analgesia that leads to development of unhealthy addiction to the used drug (Smith & Saiki, 2015). The urgency of the task of raising awareness of these complications became one of the reasons for choosing education as a topic for study.
Diagnosis
Diagnosis of pain can be complicated by cancer patients’ choice to conceal this information due to a lack of desire to show their physical or psychological vulnerability. In such patients, close observation of movement and face expressions together with palpating could be seen as preferable strategies for pain identification (Smith & Saiki, 2015). In cases when a patient is willing to cooperate, a set of questions aimed at locating the source and nature of pain is also helpful for devising an adequate pain management plan and education strategy (Smith & Saiki, 2015).
Conclusion
Considerations for pain management can and should be derived from the type of cancer and the stage of its progression. Thus, an education strategy needs to be built on that data gathered through one of diagnostic methods. Education seems to be a necessary intervention based on the prevalence of pain therapy non-inclusion and the high incidence of painful cancer cases. On the basis of the gathered background information the following PICOT question was devised: In adults with cancer (P), how effective are education programs (I) about pain management and options for pain treatment verses no education (C) program in improving patient comfort while battling cancer (O) over a 6 month time period (T)?
References
Siegel, R., Ma, J., Zou, Z., & Jemal, A. (2014). Cancer statistics, 2014. CA: A Cancer Journal for Clinicians, 64(1), 9-29.
Smith, T. J., & Saiki, C. B. (2015). Cancer pain management. Mayo Clinic Proceedings, 90(10), pp. 1428-1439.