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Pain Management in the Cancer Survivor
Institution:1. Director Advanced practice and Clinical Integration, The University of Arizona Cancer Center, The University of Arizona, Tucson, AZ;2. Head and Neck and Supportive Care, The University of Arizona Cancer Center, Tucson, AZ;1. School of Nursing, University of Michigan, Ann Arbor, MI;2. Phyllis F. Cantor Center for Research in Nursing and Patient Care Services, Dana-Farber Cancer Institute, Boston, MA;1. University of Florida College of Nursing, Gainesville, FL;2. University of Maryland School of Nursing, Department of Pain and Translational Symptom Science, Baltimore, MD;1. Palliative Care & Rehabilitation Medicine, UT MD Anderson Cancer Center, Houston, TX;2. The Center For Relationships, Austin, TX;3. Billings Clinic Collaborative Science and Innovation, Billings, MT
Abstract:ObjectivesTo describe assessment and interdisciplinary management of pain in the cancer survivor over the continuum of cancer care.Data SourcesReview of the literature and treatment standards.ConclusionPain remains a primary concern throughout the cancer trajectory across all age groups and diagnoses, emphasizing the need to integrate pain assessment and management across the continuum of cancer survivorship and across care settings. Types of pain, pain patterns, assessment of cancer pain in cancer survivors, current strategies and challenges for management, and effective communication and documentation of the process are described. Communication between and among health care clinicians in a way that effectively articulates the individual patient experience, including documentation in the electronic medical record, requires consistent workflows and terminology. The opioid crisis increases the urgency in effective strategies for interdisciplinary pain assessment and management.Implications for Nursing PracticeOncology clinicians must be able to adequately assess pain, track pain over time, understand and implement a cadre of strategies to manage pain, and effectively pursue any suspicious pain patterns that may indicate recurrence or progression of cancer or other underlying etiologies. The oncology nurse is at the core of patient-clinician communication, critical to effectively describing pain as experienced by the individual patient and continues to play a key role in maintaining consistency of message that is necessary to manage pain over the continuum of cancer survivorship.
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