Longnecker's Anesthesiology > Part 8. Care of the Chronic Pain Patient > Chapter 94. Palliative and Cancer Pain Care Phillip C. Phan, MD, and Allen W. Burton, MD

Assessment

"Pain is always subjective and is experienced only by the patient. Over the past 20 years, the assessment of pain has been the subject of much research and refinement of techniques and instruments. A brief review is presented in here; the reader is directed to the references for more details on the assessment of cancer pain. In addition to evaluating the pain symptom, the physician must focus on a myriad of related symptoms. The cancer patient often experiences fatigue, insomnia, depression, anxiety, somnolence, and even cognitive impairment. The psychosocial symptoms, such as anxiety and depression, often can have a large impact on the patient's perception and expression of pain. Furthermore, the patient can develop symptoms from side effects of therapeutic intervention, such as nausea, vomiting, and headaches. Thus, the cancer patient commonly presents with a constellation of symptoms that has a profound impact on the patient's psychological well-being, functional status, and quality of life.Many pain clinics use a questionnaire to aid in and standardize assessment. The Wisconsin Brief Pain Inventory (BPI) and Memorial Pain Assessment Card are well-accepted, standard tools for evaluating cancer pain.^10,11 At The University of Texas MD Anderson Cancer Center, an institutionally approved MD Anderson questionnaire (modified BPI) is used for initial and followup assessment of patients (Fig. 94–1).1. It is a 15-minute questionnaire, which can be self-administered.

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