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Key Points
➤ Chronic pain can be a serious, negative consequence of surviving
cancer.
➤ Although estimates vary, the prevalence of pain in cancer survivors
has been reported to be as high as 40%.
Screening And Comprehensive Assessment
➤ Clinicians should screen for pain at each encounter. Screening
should be performed and documented using a quantitative or
semiquantitative tool. (Strong Recommendation; IC-B-I)
➤ Clinicians should conduct an initial comprehensive pain assessment.
(Moderate Recommendation; IC-B-I)
• This assessment should include an in-depth interview that explores the
multidimensional nature of pain (pain descriptors, associated distress, functional
impact, and related physical, psychological, social, and spiritual factors) and
captures information about cancer treatment history and comorbid conditions,
psychosocial and psychiatric history (including substance use), and prior
treatments for the pain.
• The assessment should characterize the pain, clarify its cause, and make inferences
about pathophysiolog y. A physical examination should accompany the history,
and diagnostic testing should be performed when warranted.
➤ Clinicians should be aware of chronic pain syndromes resulting from
cancer treatments, the prevalence of these syndromes, risk factors
for individual patients, and appropriate treatment options. (Moderate
Recommendation; IC-B-I)
• A list of common cancer pain syndromes can be found in Table 1.
➤ Clinicians should evaluate and monitor for recurrent disease, second
malignancy, or late-onset treatment effects in any patient who reports
new-onset pain. (Moderate Recommendation; IC-B-I)
Diagnosis
