Cancer Pain: Assessment and Management

Question 1

Palliative

The most common cancer-related symptom that radiation oncologists are called
upon to assess and manage is cancer-related pain

TRUE or FALSE?

Answer 1

True

Question 2

Cancer Pain

Cancer-related pain can also result from the delivery of RT and subsequent
complications to normal tissues.
Which of the following is true?

I. Acutely, irradiation of normal tissues with a rapid growth rate causes cell death and triggers a cascade of cytokines and
thrombotic and growth factors, propagating local painful reactions.

II. RT can cause pain because of
late or chronic tissue damage such as fibrosis and damage to local microvasculature.

Answer 2

Both are true

Question 3

Cancer Pain

This type of pain refers to the nervous system response that is proportional to the tissue damage initiating the response

Answer 3

Nociceptive pain

Question 4

Cancer Pain

This type of pain results from irritation and activation of peripheral or central nerves

Answer 4

Neuropathic pain

Question 5

Cancer Pain

Using the “PAINED” acronym, medications that relieve the pain is classified under which parameter/letter?

Answer 5

“N”
nullifier

P- place/location
A- activators/aggravators
I- intensity/interval
N- nullifier/reliever
E- effect on activities
D- is not drugs. It's the description of pain by the patient's own words.

Question 6

Cancer Pain

What are the recommended pharmacologic interventions based on the different steps in the WHO Pain Ladder?

Answer 6

I - NSAIDs and non-opioids
II - weak opioids (codeine, tramadol)
III - strong opioids (morphine/oxycodone)

Question 7

Cancer Pain

This antiemetic causes consitpation and should not be used to treat nausea induced by opiates, especially if the patient already presents with constipation.

Answer 7

Ondansetron

Question 8

Cancer Pain

What is the peripherally cting opioid antagonist that can be used for constipation refractory to dietary and stool modifiers?

Answer 8

methylnaltrexone

Question 9

Cancer Pain

Adding these medications to the regimen can decrease a patient’s dose of opioids in the setting of opioid adverse reactions.

Answer 9

glucocorticoids,
anticonvulsants,
antidepressants

Question 10

Cancer Pain

Glucocorticoids can help decrease neuropathic pain in conjunction with palliative RT.

Aside from these, what are the renally excreted anticonvulsants that are considered first-line drugs for neuropathic pain due to low drug–drug interactions?

Answer 10

gabapentin and pregabalin

Question 11

Cancer Pain

Complementary therapies such as accupuncture is proven by randomized trials to be effective in treating cancer pain.

TRUE or FALSE?

Answer 11

True.