Pain is a personal and subjective experience of each individual. Objectivity in such situation of acute pain management techniques is very difficult. So the best way out of this is: “If patient says it hurts, then it hurts!”
After accepting the pain, then try to quantify or assess the severity of the pain using acute pain management techniques . It is useful in initiating the treatment or deciding which level of intensity of management is to be used.
Pain has not only a somatosensoly, or autonomous aspect, but a large ‘psycho-behavioural’ angle too.
In terminally ill cancer patients, ‘sense of helplessness’ and fear of impending death adds to total suffering of the patient. So the acute pain management techniques must be aimed at physical, mental, spiritual, personal, interpersonal levels with idea of achieving ‘balanced and total relief’.
‘Addiction’/ ‘dependence’ are meaningless fears in the patients with terminal pain. It is of no consequence if such a terminally ill patient does get addicted to opioids or sedatives/anxiolytics. If the quality of life is going to improve due to use of such drugs, then it is worth its value.
The patients with cancer may also have pain of non- cancerous origin. It is better to diagnose, using acute pain management techniques to find out the cause, classify the pain and thus control it.
Chronic cancer pain is more or less like an ongoing process—a progressive disorder. It is not like acute pain of treatable disease, where cause is removed and pain will subside. Rather, in most of the cancer patients, cause cannot be removed and pain increases even after acute pain management techniques .
Hence it is absolutely essential to constantly assess acute pain management techniques and evaluate the severity, plan the appropriate therapy, adjust doses, keep on changing the protocol of drugs so as to achieve maximum optimization of control of pain.
The associated complaints, symptoms which may be due to cancer itself or secondaries or may be side effects of therapeutic or interventional measures, also must be kept in consideration and continuously monitored and treated.
Psychological support, counseling, family and relatives’ positive attitude, religious support, and acute pain management techniques go a long way in improving the general quality of life of these patients.