Pain Management in the Oncology Unit Say no to plagiarism. Get a tailor-made essay on "Why Violent Video Games Shouldn't Be Banned"? Get an original essay Pain has been one of the most painful symptoms of cancer. It affects the quality of life of patients, their families and their caregivers. Being moderate to severe, pain is very common and its prevalence increases over the course of the disease (Kwon, 2014). Although cancer pain is usually adequately controlled through pain management for most patients, however, the problem continues to be undertreated due to several factors (Adam et al., 2017). This essay presents the case encountered during a clinical internship of a student in the Oncology department in which Mia (pseudonym), a 29-year-old woman, presented for a routine check-up after having undergone a bilateral mastectomy about 2 years ago and since he then received a combination of external beam radiation, chemotherapy, and hormonal agents. At that time, Mia was referred to the oncology department following a routine breast screening ordered by her family doctor due to her strong family history of breast cancer, which her mother had diagnosed at the age of 30. After surgery, Mia suffered from chronic pain. even though she was provided with adequate pain management. After the visit, the formation of lymphedema in the axilla was found. Among women worldwide, cancer is the leading cause of death in high-income as well as middle-income countries. Furthermore, the burden of cancer is continually expanding in countries with all types of income levels due to the growing number of aging populations. Throughout the course of cancer, from diagnosis and treatment to long-term management, patients are faced with multiple factors that impact their professional, personal, physical, and emotional status (Torre, Islami, Siegel, Ward, & Jemal, 2017 ). This essay will include six criteria that could be used to improve the learning/information journey of new graduates dealing with patients suffering from post-operative cancer pain. The six areas include; Patient empowerment, use of postoperative integrative therapies, post-mastectomy body image, pain management through physical training, pain assessment, and pain resulting from lymphedema formation. Breast cancer is the most diagnosed cancer and leading cause of mortality among women worldwide (Torre et al., 2017). Mia has had several personal problems that have had a great impact on her life. Aside from her obesity, Mia is physically inactive, suffers from type 2 diabetes mellitus, and has struggled with alcohol abuse since her mother's death. According to Torre et al. (2017), factors such as family history of the disease, reproductive factors influencing exposure to endogenous estrogens, physical inactivity, alcohol consumption, excess body weight, high-dose radiation to the chest, and l The use of exogenous hormones has a strong link with breast cancer. Pain management is a very important aspect in the quality of life of a seriously ill individual. Around 60% of women suffer from persistent pain after breast cancer treatment, which is often not adequately recognized and therefore often undertreated. Inadequate pain assessment and a lack of knowledge of the pain mechanism are among the common barriers to adequate pain management (Schou Bredal, Smeby, Ottesen, Warncke, & Schlichting, 2014). Sensory or motor symptoms and disturbances such as weakness, pain, tightness, nerve paralysis, poor mobility, altered movement patterns, or swelling in the arm,to the shoulder and/or breast on the affected side are problems that can result from breast cancer ( Hayes et al., 2012 ). The root of cancer pain is quite complex and arises from problems such as edema around a tumor, the tumor itself, or metastasis to the nerves, tissues, or bones, or may even be related to the treatment of the cancer itself. After surgery. , Mia suffered from chronic pain that did not seem to decrease, even though adequate pain management was provided. On a scale of 10, he rated his pain as a 6-7. He states that the pain worsens with elevation or when supporting a certain weight (about 5 kg). He describes the pain as worse when lying down or performing repetitive movements. She was seen by her pain specialist and he concluded that she previously had underlying breast pain that had increased in intensity following the breast surgery. An analysis conducted by Langford et al. (2015) concluded that women who had preoperative breast pain are at risk for more severe postoperative pain, loss of sensation at the breast scar site, reduced shoulder flexion, and poorer physical well-being. An article by Hayes et al. (2012) studied 7 cohort studies involving population-based samples at 6, 12, 18, 24, and 36 months after diagnosis/breast surgery, and the table below shows the results. Cancer pain persists even 36 months after breast cancer diagnosis/surgery, with 19% to 54% experiencing at least one symptom. Poor cancer pain management is associated with reduced quality of life and impaired daily functioning. This often leads to increased emergency room visits and sometimes hospitalization. Furthermore, inadequate pain management can lead to cessation of cancer treatments (Jacobsen & Snyder, 2018). Below is some information that new graduate nurses could use when undertaking Mia's care. Patient empowerment Patient empowerment in cancer pain management is a very important aspect of their care and has been highlighted as playing a key role in pain management. This gives the patient the opportunity to take control of their care without judgment from their doctor, but to understand their needs and do what is in their best interest. An integrative review of several articles conducted by Te Boveldt et al. (2014) suggested that a cyclical model seemed more appropriate in managing cancer pain. He highlighted that previous research focused on pain treatment provided by healthcare professionals or active patient participation. Te Boveldt et al. (2014) suggested, improving quality of life and managing side effects of cancer therapy. Patients using behavioral therapies, such as mindfulness, meditation, relaxation and yoga, showed strong improvement in mood in the context of anxiety and depression during cancer treatment. Massage and stress management for improving energy and mood were the least recommended. During radiation therapy and chemotherapy, music therapy is recommended to provide short-term relief from anxiety. To improve depression and mood during radiotherapy and after treatment, meditation is recommended. Enhancement programs such as energy, sleep, and healing touch may be considered when treating pain during chemotherapy. Meditation has shown a strong link with improved quality of life (Greenlee et al., 2014). Body image after mastectomy It is a very delicate issue when dealing with body imageof a woman, especially after cancer surgery. Patients are very concerned about their health, but they also worry about how their body image will change later. When nurses are dealing with women (no matter how old), it is sometimes a rather sensitive topic to discuss. A study conducted by Grogan and Mechan (2017) on 49 women aged 29 to 53 (8 had bilateral surgery and 41 had unilateral mastectomy) to examine the positive and negative impact mastectomy has on their image corporeal. The women's priority was survival and at the time of diagnosis they were more worried about their health than what their body image might look like. However, some women, especially those who had undergone a unilateral mastectomy, were very upset because their body was no longer symmetrical. Mentally they were not ready to accept that a part of their body, which seemed damaged, had been removed. They felt lost and out of touch with themselves. Pain management through physical activity The prevalence of pain among breast cancer patients is high and is almost inadequately treated because the intensity of pain is not identified or the severity of pain is underestimated. Pain is reduced with physical training and this increases cardiorespiratory fitness, strength, flexibility and quality of life, thus reducing length of hospital stay, fatigue, depression, anxiety, sleep disturbances , stress, nausea and vomiting (Reis et al., 2018). A controlled pilot study by Reis et al. (2018) on 28 patients aged between 30 and 59 years underwent a 12-week training course, comprising 60-minute sessions of resistance training and exercises and two sessions of 3 sets of 20-second flexibility training per week . The results showed that the combined training reduced total pain intensity, tender points and pain interference in the patients' daily lives, as well as increased flexibility, oxygen consumption and strength. Pain assessment Cancer-related pain is difficult to assess and control due to its subjective nature. , its extent and complexity of cancer. When the correct assessment is not undertaken or performed incorrectly, the result is inadequate pain control. A comprehensive evaluation of cancer pain focuses on the location, quality and type of pain, history of pain (duration, onset and course), intensity, temporality (intermediate, constant or intermittent), and radiation of pain to other parts of the body. Comprehensive pain assessment at regular intervals is critical for optimal pain management. This can help in obtaining an adequate assessment and then appropriate treatment can be offered and can help improve physical functioning, psychological and emotional state, performance of activities of daily living and better social interaction. If verbal assessment is not appropriate in some patients, alternative pain assessment tools may be needed (Gallagher, Rogers, & Brant, 2017). Pain resulting from lymphedema formation Lymphedema is and remains the largest complication of breast cancer therapy. It is the lesion of the axillary lymphatic system that causes the accumulation of lymphatic fluid in the interstitial space thus causing the swelling of the vessels. Fluid may build up in the arm, hand, or breast that has received axillary radiation therapy. Even if you don't notice any visible changes, lymphedema causes a sensation of numbness, heaviness, or tingling. Chronic lymphedema may increase in severity and course..