CANCER PAIN IN PALLIATIVE CARE: ASSESSMENT, MONITORING, AND THE ROLE OF NURSING
DOI:
https://doi.org/10.31435/ijitss.3(51).2026.5774Keywords:
Chronic Pain, Breakthrough Pain, Palliative Care, Pain Assessment, Cancer PainAbstract
Cancer is one of the leading causes of death, following cardiovascular diseases. Despite significant advances in medicine, cancer incidence continues to rise, with the number of affected individuals having doubled over the past decades. Pain is the most common symptom experienced during the course of cancer. On average, approximately half of patients with cancer, at various stages of the disease, suffer from pain. According to the concept proposed by Cicely Saunders, founder of St Christopher’s Hospice in London, cancer pain is a multidimensional and overwhelming experience referred to as “total pain” which includes physical, psychological, social, and spiritual components. The aim of this study is to present the issue of pain in the course of cancer, to define appropriate nursing management strategies for the assessment and monitoring of this symptom, and to provide a descriptive analysis of current knowledge on pain and its treatment. This paper is based on a review of the relevant literature, including textbooks, scientific articles, and current legal regulations. It consists of three chapters addressing palliative care, the characteristics of cancer pain, and principles of nursing management in its assessment and control.
References
de Walden-Gałuszko, K., & Ciałkowska-Rysz, A. (2015). Palliative Medicine. Wydawnictwo Lekarskie PZWL, Warsaw
Kaptacz, A., Walden-Gałuszko, K., & Kaptacz, I. (2023). Palliative Care Nursing, Vol. II. Wydawnictwo Lekarskie PZWL, Warsaw
Radbruch, L., & Payne, S. H. (2010). White Paper on standards and norms for hospice and palliative care in Europe: part 2. Recommendations from the European Association for Palliative Care , 17:22-33
Tanaka T de, L., Mendes J da, S. A., Barreto, J. R. F., et al. (2024). Palliative Care Fundamental Principles and Interdisciplinary Approaches. Revista de Gestão Social e Ambiental -. RGSA , 18:07174-07174. https://doi.org/10.24857/rgsa.v18n8-146
Connor, S. T., & Sepúlveda, C. (2014). The Global Atlas of Palliative Care at the End of Life. Stephen Connor, Cecilia Sepulveda (ed): Worldwide Hospice Palliative Care Alliance, World Health, London;
Radbruch, L., & Payne, S. H. (2009). White paper on standards and norms for hospice and palliative care in Europe: Part 1. European Journal of Palliative Care , 16:278-289
Wordliczek, J., & Dobrogowski, J. (2017). Pain Management, Vol. III. Wydawnictwo Lekarskie PZWL, Warsaw
Availability of Pain Therapy - Supreme Audit Office. Supreme Audit Office (NIK). (2017)., A. C. C. E. S. S. E. D. (2026). March 20. : https://www. nik.gov.pl/kontrole/wyniki-kontroli-nik/kontrola
Pain control in palliative care. (2022)., A. C. C. E. S. S. E. D. (2026). March 20. : https://patient. info/doctor/oncology/pain-control-in-palliative-care
Caraceni, A., Hanks, G., Kaasa, S., et al. (2012). Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC. Lancet Oncology , 13:58-68. https://doi.org/10.1016/S1470-2045(12)70040-2
Komendarek-Kowalska, M. (2018). Quality of life of a patient with cancer. Pain and depression - severity of symptoms depending on gender. Medycyna Paliatywna/Palliative Medicine , 10:30-6. https://doi.org/10.5114/pm.2018.77204
Caraceni, A., & Shkodra, M. (2019). Cancer Pain Assessment and Classification. Cancers (Basel , 11:510. https://doi.org/10.3390/cancers11040510
van den Beuken-van Everdingen, M. H. J., de Rijke, J. M., Kessels, A. G., Schouten, H. C., van Kleef, M., & Patijn, J. (2007). Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol , 18:1437-49. https://doi.org/10.1093/annonc/mdm056
Knaul, F. M., Farmer, P. E., Krakauer, E. L., et al. (2018). Alleviating the access abyss in palliative care and pain relief—an imperative of universal health coverage: the Lancet Commission report. The. Lancet , 391:1391-454. https://doi.org/10.1016/S0140-6736(17)32513-8
Treede, R. D., Rief, W., Barke, A., et al. (2019). Chronic pain as a symptom or a disease: the IASP Classification of Chronic Pain for the International Classification of Diseases (ICD-11). Pain , 160:19-27. https://doi.org/10.1097/j.pain.0000000000001384
Raja, S. N., Carr, D. B., Cohen, M., et al. (2020). The revised International Association for the Study of. Pain definition of pain: concepts, challenges, and compromises. Pain , 161:1976-82. https://doi.org/10.1097/j.pain.0000000000001939
Mills, S. E. E., Nicolson, K. P., & Smith, B. H. (2019). Chronic pain: a review of its epidemiology and associated factors in population-based studies. Br J Anaesth , 123:273-83. https://doi.org/10.1016/j.bja.2019.03.023
Bair, M. J., Robinson, R. L., Katon, W., & Kroenke, K. (2003). Depression and pain comorbidity: a literature review. Arch Intern Med , 163:2433-45. https://doi.org/10.1001/archinte.163.20.2433
Fallon, M., Giusti, R., Aielli, F., Hoskin, P., Rolke, R., Sharma, M., & Ripamonti, C. I. (2018). Management of cancer pain in adult patients: ESMO Clinical Practice Guidelines†. Annals of Oncology , 29:166-91. https://doi.org/10.1093/annonc/mdy152
Woroń, J. (2020). Drug selection in the treatment of breakthrough pain: how the pharmacokinetic profile of drugs is to be translated into clinical practice. 4:38-42. https://doi.org/10.5603/PMPI.2019.0021
Nowak, Ł. R. (2015). Management of Breakthrough Pain in Patients with Malignant Neoplasms. Medycyna Praktyczna (mp. pl) , 3:40-43
Malec-Milewska, M., Krajnik, M., & Wordliczka, J. (2014). The Cancer Patient – A Compendium of Pain Management. Vol. II. Medical Education, Warsaw;
Radbruch, L., De Lima, L., Knaul, F., et al. (2020). Redefining Palliative Care-A New Consensus-Based Definition. Journal of Pain and Symptom Management , 60:754-64. https://doi.org/10.1016/j.jpainsymman.2020.04.027
World Health Organization. Cancer Pain Relief., G. E. N. E. V. A. (1986). WHO;. (1986). Accessed: March 26, 2026: https://iris.who.int/server/api/core/bitstreams/d1dda41f-a909-4875-9a94-707cfb308267/content
Woroń, J., Dobrogowski, J., & Wordliczka, J. (2011). Pain Management Based on the WHO Analgesic Ladder. Medycyna po Dyplomie , 20:52-61
Bisaga, W., Dorazil, M., Dobrogowski, J., & Wordliczek, J. (2011). Comparison of the Usefulness of Selected Neuropathic Pain Assessment Scales in Patients with Chronic Pain Syndromes: A Short Report. Palliative Medicine in Practice , 5:22-26
Janecki, M. (2014). Review of Tools for the Assessment of Neuropathic Pain. Palliative Medicine in Practice , 8:74-77
Treede, R. D., Jensen, T. S., Campbell, J. N., et al. (2008). Neuropathic pain: redefinition and a grading system for clinical and research purposes. Neurology , 70:1630-5. https://doi.org/10.1212/01.wnl.0000282763.29778.59
Ciałkowska-Rysz, A., & Dzierżanowski, T. (2014). Review Articles and Guidelines. Basic Principles of Pharmacotherapy of Pain in Patients with Cancer and Other Chronic, Progressive, Life-Threatening Diseases. Medycyna Paliatywna/Palliative Medicine , 6:1-6
End-of-Life Care During the Last Days and Hours | RNAO.ca., A. C. C. E. S. S. E. D. (2026). April 6. (2025). Accessed: April 6, 2026: https://www.uptodate.com/contents/palliative-care-the-last-hours-and-days-of-life
Carpenter, J. G., & Berry, P. H. (2012). Refractory Cancer Pain in a Nursing Home Resident. Journal of Hospice & Palliative Nursing , 14:516. https://doi.org/10.1097/NJH.0b013e318273b983
Betty J., A. C. K. L. E. Y., & Gail B., L. A. D. W. I. G. (2011). Handbook of Nursing Diagnoses. Vol I. Danuta Zarzycka, Barbara Ślusarska (ed): Wydawnictwo Lekarskie PZWL, Warsaw;
Becker, R. (2009). Palliative care 3: using palliative nursing skills in clinical practice. Nursing Times , 105:18-21
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Magdalena Bodera, Radosław Szydłowski, Anna Kaźmierska, Dominik Bylica, Sonja Rozmus, Anna Hamerla, Julia Gawron

This work is licensed under a Creative Commons Attribution 4.0 International License.
All articles are published in open-access and licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0). Hence, authors retain copyright to the content of the articles.
CC BY 4.0 License allows content to be copied, adapted, displayed, distributed, re-published or otherwise re-used for any purpose including for adaptation and commercial use provided the content is attributed.

