An integrative review of literature found that cancer is associated with complex pain symptoms that should be managed by an interdisciplinary team. These findings were published in Palliative Care & Social Practice.

Cancer is often diagnosed in its advanced stage and 70% to 90% of patients with advanced cancer report symptoms of pain. When pain is not adequately managed, patients can experience physical, emotional, and spiritual symptoms that can harm activities of daily living, cognition, and sleep.

To evaluate the spectrum of pain in cancer, investigators from Universidade de São Paulo in Brazil searched for studies published between 2002 and 2020 about cancer pain.

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A total of 21 articles addressing themes of multidimensionality of pain in cancer (13) and evaluation and management of pain (8) were included in the review.

Pain should be globally assessed as it can affect physicality and psychosocial features. Depending on the observed features, patients may require interventions for mood disorders and cognitive difficulties in addition to pain interventions. The investigators observed that the severity of pain may be strong and independent predictors of emotional distress, exacerbating associated symptoms.

Some studies indicated that men and women may experience distress differently, in which women may be more likely to be affected by changes to their appearance, sexual function, and family problems whereas men may be more likely to present with spiritual pain and feelings of hopelessness, uselessness, and loneliness.

Although the investigators emphasized the importance of systematic pain assessment, they acknowledged the inherent difficulty as pain is subjective and can be difficult for patients to describe. The investigators recommended using multidimensional instruments and collaboration among a multidisciplinary team to address patient needs.

This review of the literature found that pain in cancer should be evaluated and treated holistically by a multidisciplinary team.


Gomes-Farraz CA, Rezende G, Fagundes AA, Rodrigues do Prado De Carlo MM. Assessment of total pain in people in oncologic palliative care: integrative literature review. Palliat Care Soc Pract. 2022;16:26323524221125244. doi:10.1177/26323524221125244