BREAST CANCER PAIN

Challenging and Changing the Experience of Pain

[Pain as it relates to a client with Breast Cancer]

BY

IRENE I. UKE, RN

Table of Contents

Introduction3

Definition for Pain4

Types of Pain5

Nociceptive Pain5

Neuropathic Pain5

Somatic Pain5

Visceral Pain5

Acute Pain6

Chronic Pain6

Pain Management7

Pharmacological Pain Management:7

Routes of Administration of Step 3 Drugs:8

Implementation:8

Non-Pharmacological Pain Management :9

Complementary / Alternative Therapy11

Physical Pain Crisis:12

Other Pain Impact on Patient Relationships and Quality of Life:13

Pain Impact:14

Some Client Issues:14

Understanding the Role of the Healthcare Personnel:15

Pain Assessment:15

Pain Assessment Process:16

Planning Intervention17

Pain Management Evaluation17

Pain Assessment Tools and Instrument:17

Difficulties in Improving Pain Management:18

Final Thought:18

Conclusion19

References20

Breast Cancer Pain

Introduction

The diagnosis of Breast Cancer can have a major impact on the patient and her family. Just hearing the word “cancer” causes many people to shudder. Fortunately, thanks to advances in modern medicine, Breast Cancer can now be controlled as well as the pain associated with Breast Cancer. Breast Cancer has become has become much more treatable in recent years with ever increasing survival rate. (Jemal, et al. 2008)

This paper will focus on pain as it relates to Breast Cancer patients, their loved ones, physical pain crisis, psychological distress, financial constraints or pressure. It will also focus on pain assessment definition, types of pain, pharmacological and non pharmacological pain management and care given as some of the few challenging ways to alleviate pain to a tolerable state to elicit comfort and peace, and to conclude with some final thoughts on what the implications are for future clinical practice.

This paper discusses a nurse's experience in taking care of a patient that was diagnosed with breast cancer. Patient A is a 67-year old widowed African American female who was diagnosed with Stage 4 breast cancer. She had never done breast self-examination or had a mammogram prior to her diagnosis. After she was diagnosed, the physician informed her that she was not a candidate for surgery or chemotherapy. She declined taking radiation therapy as well as hospice care.

She had constant pain that affected her quality of life; she also became depressed and withdrawn from her family and friends. She lost all interest in doing things she once did. She had 7 children and 19 grandchildren whom she helped raised. She ran a home daycare up until she turned 60. She enjoyed fishing, dancing, volunteering at her neighborhood YMCA (youth activity center), and singing in her church choir. She had always been an independent and strong role model for her family.

Concerning her pain level, she had unrelieved pain, but when asked during assessment, she would deny having any. We used other terms besides pain to ascertain her pain level. We used words like “ache”, “soreness”, and “hurting”. We also looked for clues like facial expressions, body positioning, body language and perspiration, neglect in her Activities of Daily Living (ADL) and Instrumental Activities of Daily Living (IADL). Her family reported that her pain interfered with her sleeping, eating, socializing and performing her daily routine. She would restrict her activity to stay pain-free so that she would not admit to her nurses and family of having pain. During the first week of ...