What are the initial National Comprehensive Cancer Network recommendations for cancer pain screening and assessment?
NCCN recommends the following: Screen all patients with cancer for pain. If no pain is present, rescreen at each visit. If pain is present, use a pain intensity rating scale to determine rates of current, usual, worst, and least pain in the past 24 hours. Treat severe, uncontrolled pain immediately. Conduct a comprehensive pain assessment to determine the cause of pain, pathophysiology of pain, presence of specific cancer pain syndrome(s), and patient goals for comfort and function. Anticipate anxiety about painful events and procedures and offer analgesics (topical, local, or systemic) and anxiolytics for procedures causing pain or anxiety.
In nonverbal patients, use alternative methods for evaluating the level of pain—for example, observe patient behavior (withdrawal, grimacing), obtain family/caregiver input on the patient’s behavior and its meaning, and evaluate the patient’s response to pain medication and nonpharmacological treatments.