Measuring cancer pain

Doctors measure cancer pain so they can give you the right treatment. This can include asking questions, examining you and rating your pain on a scale.

Assessing cancer pain

Before your doctor or nurse can manage your pain, they will need to ask you a series of questions about the history of your illness and pain. This is called a pain assessment.

This might seem like a lot to deal with if you're in pain at the time. You probably just want them to give you something to relieve the pain immediately and leave you alone.

But it’s extremely important that your doctor or nurse takes the time to assess all aspects of your pain. That way you can get the right treatment. Your family or friends might be able to help if you really don’t feel up to answering questions.

Your doctor or nurse will examine you and possibly arrange some other tests and investigations.

Questions your doctor might ask

These are the types of questions that your doctor or specialist nurse might ask you.

  • Where is your pain? Is it in one place or all over your body?
  • On a scale of 0 to 10, how much does your pain hurt?
  • Does anything that you do help to lessen the pain? For example, changing position, or applying heat or cold?
  • What does the pain feel like? For example, stabbing, tingling, aching, burning, throbbing, cramping or shooting?
  • If you’ve had treatment such as chemotherapy or radiotherapy, has the pain got worse or better?
  • Do you have any other medical conditions?
  • Do you take any medicines to help with your pain?
  • Does eating make the pain worse?
  • How long is it since you opened your bowels?
  • Do you have any problems passing urine?

Pain examinations and tests

Next, your doctor or nurse will examine you. Depending on where your pain is, they might:

  • examine your abdominal area, hips, spine, hands and feet
  • feel for enlarged lymph nodes under your arms, in your groin or at the base of your neck
  • give you an x-ray or blood tests to get more information

Pain scales and diaries

Another way of assessing your pain is to ask you to rate it on a scale.

This could be on a scale of 0 to 10, where 0 means no pain at all and 10 means the worst pain you can imagine. Some hospitals use a pain scale from 0 to 4. 

Wong-Baker pain face scale 

Your care team might use a pain faces scale. This is a well known series of diagrams ranging from very happy to very unhappy faces. It's called the Wong-Baker pain face scale. Your care team ask you to pick a face that best describes your pain. This scale is most often used with children. But it's helpful in some situations in adults who have cancer pain too.

Pain scale image

Pain scales can be a very good way of helping people describe pain. Many hospitals and hospices keep these records to refer back to when you have another pain assessment, or if your treatment changes.

Some people find it hard to rate their pain on a pain scale. You can use words like mild, moderate or severe if you find that easier.

Some people keep a pain diary. This is a daily record or report of your pain. You describe things such as where your pain is, how strong it is, what activities you’re doing and how many painkillers you need to take.

This information can help you and your doctor or nurse assess your pain, and see how well painkillers are working.

Assessing cancer pain again

Pain assessments are useful to see how well painkillers, or other ways of controlling pain, are working.

A pain assessment shouldn’t just be a one off. It is an ongoing way for the team looking after you to make sure you are getting the right medication and support you need.

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