Episode 332: Best Nursing Practices for Pain Management in Patients With Cancer

"Nurses really are the professionals who educate how to take these medicines, why we use multimodal therapies, why it isn't medicine alone—helping patients to understand that pain is a biopsychosocial spiritual phenomenon, and the pills are just going to hit one little aspect of that entire phenomenon," Judy Paice, PhD, RN, director of the cancer pain program at Northwestern University Feinberg School of Medicine in Chicago, IL, told Lenise Taylor, MN, RN, AOCNS®, BMTCN®, oncology clinical specialist at ONS, during a conversation about nursing practices for cancer pain management. Music Credit: " Fireflies and Stardust " by Kevin MacLeod Licensed under Creative Commons by Attribution 3.0 Earn 1 contact hour of nursing continuing professional development (NCPD) by listening to the full recording and completing an evaluation at courses.ons.org by October 11, 2025. The planners and faculty for this episode have no relevant financial relationships with ineligible companies to disclose. ONS is accredited as a provider of nursing continuing professional development by the American Nurses Credentialing Center's Commission on Accreditation. Learning outcome: Learners will report an increase in knowledge related to managing pain in patients with cancer. Episode Notes The NCPD activity for this episode has expired, but you can still earn NCPD through many other ONS Podcast episodes. Find a full list of opportunities . Oncology Nursing Podcast ™ episodes: Episode 165: Safely Administer and Prescribe Opioids for Cancer-Related Pain Episode 3: Opioids, Addiction, and Complex Care ONS Voice articles: Alternative Funding Programs: Don't Be Fooled by Promises of 'Free' Specialty Cancer Drugs CMS's Chronic Pain Experience Journey Map Will Help Patients and Providers Latest CDC Clinical Practice Guideline Facilitates Safe Use of Opioids for Pain What the Evidence Says About Tai Chi in Cancer Care ONS book: Clinical Manual for the Oncology Advanced Practice Nurse (fourth edition) ONS courses: Essentials in Advanced Practice Symptom Management Treatment and Symptom Management—Oncology RN Clinical Journal of Oncology Nursing articles: Effects of a Nurse-Initiated Telephone Care Path for Pain Management in Patients With Head and Neck Cancer Receiving Radiation Therapy Pain Management Revisited Symptom Distress: Implementation of Palliative Care Guidelines to Improve Pain, Fatigue, and Anxiety in Patients With Advanced Cancer Oncology Nursing Forum articles: Barriers for Nurses Providing Cancer Pain Management: A Qualitative Systematic Review Framing Cancer Survivors' Access to and Use and Disposal of Prescribed Opioids Within the Opioid Epidemic Interventions for Managing a Symptom Cluster of Pain, Fatigue, and Sleep Disturbances During Cancer Survivorship: A Systematic Review ONS Position Statement: Cancer Pain Management ONS Learning Library: Pain Management Diagnostics article: Diagnosing Pain in Individuals With Intellectual and Developmental Disabilities: Current State and Novel Technological Solutions End-of-Life Nursing Education Consortium Harvard Implicit Association Test National Cancer Institute's Cancer Pain PDQ Health professional version Patient version Opioid Risk Tool Pain Medicine article: A Tactile Pain Evaluation Scale for Persons With Visual Deficiencies To discuss the information in this episode with other oncology nurses, visit the ONS Communities . To find resources for creating an Oncology Nursing Podcast Club in your chapter or nursing community, visit the ONS Podcast Library . To provide feedback or otherwise reach ONS about the podcast, email pubONSVoice@ons.org . Highlights From This Episode "Who do patients speak to about their pain? They're often afraid to tell their oncologist, and studies have backed this up. The patient is worried that if they admit to more symptoms, they won't be able to enroll in that clinical trial, so they talk to us, the nurse. And part of our role is to encourage that dialog and assess the pain fully." TS 7:00 "The nonpharmacologic, which is equally important—and I see these as partners in relief, not as one versus the other. But we may have physical measures like [physical therapy] and [occupational therapy] and orthotics, heat and cold. We may have more emotional or psychological kinds of therapies—cognitive behavioral techniques. We may have integrative measures—mindfulness guided imagery, yoga, tai chi. And some of these kind of transcend multiple categories." TS 15:57 "For breakthrough [pain], we try to again treat the underlying cause. If this is an unstable vertebral body, is a kyphoplasty or vertebroplasty a possibility for this patient? If there's compression of nerve roots, might an epidural steroid injection or some other interventional procedure help, so that when the patient stands—and that's often what we see the breakthrough pain occurring—or moves position, maybe we can provide some relief that's more directed to the site of pain or source." TS 24:35 "I set expectations. Again, this is where nurses are key. It is so important that you use these medicines for pain. Yes, they're going to make you feel a little bit less anxious, a little warm and fuzzy, and maybe even help you fall asleep at night, but you cannot use them for that purpose. You can only use these medicines for pain control. We have other medicines to help you if you're feeling anxious or if you're having trouble sleeping at night. And if you use your opioids for those purposes, you are going to get into trouble." TS 41:11