Exploring the Complexity of Cancer-related Pain

Exploring the Complexity of Cancer-related Pain is organized by The Royal Marsden School and will be held from Jan 10 - Feb 21, 2025.

Course Summary:
Cancer-related pain is complex, multifactorial, and has a detrimental impact on individuals’ quality of life as it impacts not only the physical domains but also a significant impact on psychosocial domains (Sun et al 2007). Despite the complex nature of persistent cancer-related pain, it remains poorly understood and managed (Bouya et al 2019, Sun et al 2007). This module will equip healthcare professionals with the knowledge, skills, and confidence in order to support those impacted by cancer-related pain. The module and its content is aligned to Skills Multidisciplinary Guidance (UKONS, 2018) as well as the RCN/UKONS/HEE (2022) Career Pathway and Education Framework and the four pillars of Advanced Clinical Practice (HEE, 2017).

The overall aim of this module is to explore all aspects of cancer-related pain from the physiological, social, spiritual, and cultural factors that impact an individual’s journey through cancer treatment. It will ensure that healthcare professionals have a broad understanding of the impact of cancer-related pain and how they can support those impacted by it.

Learning Outcomes:
On successful completion of the module at Level 6 you should be able to demonstrate achievement of the following learning outcomes:

• Explore the physiological mechanisms involved in cancer-related pain transmissions and discuss the difference between acute, chronic, nociceptive, and neuropathic pain states
• Discuss the concept of ‘total pain’ and link this back to the individual living with and beyond cancer
• Demonstrate the ability to perform a holistic pain assessment that addresses all aspects of the ‘total pain’ experience
• Discuss your role within the wider interdisciplinary team in the assessment and management of cancer-related pain
• Identify the components of a multi-modal pain management plan that addresses the total pain experience and includes both pharmacological and non-pharmacology interventions

On successful completion of the module at Level 7 you should be able to demonstrate achievement of the following learning outcomes:

• Examine and comprehensively understand the physiological mechanisms involved in cancer-related pain transmissions and outline the difference between acute, chronic, nociceptive, and neuropathic pain states
• Critically explore the concept of ‘total pain’ and relate this back to the individual living with and beyond cancer
• Demonstrate the ability to perform a holistic pain assessment that addresses all aspects of the ‘total pain’ experience
• Critically discuss the role of the wider interdisciplinary team and explore their roles in the assessment and management of cancer-related pain
• Develop a pain management plan that addresses the total pain experience by adopting non-pharmacological and pharmacological treatment modalities with a critical discussion of the rationale for your choice

Key Topics:

• Exploration of pain definitions and concepts of ‘total pain’ and ‘biopsychosocial’ models
• Exploration of the emotional and psychological impact of pain on an individual’s quality of life
• Pain physiology including mechanisms of nociceptive, neuropathic pain and the development from acute to chronic pain
• Exploration of healthcare professionals’ roles and attitudes towards pain assessment and management and how these impacts on the pain experience
• Explore the aspects of what makes a good pain assessment and the selection of appropriate assessment tools
• Holistic needs of the family / career of the individual living with and beyond cancer related pain
• Understanding the psychological impact of pain and how these impacts on the pain experience 
• Explore the importance of communication skills when managing persistent pain states
• Discuss the pharmacodynamics and evidence base for opioid and non-opioid analgesia 
• Discuss the role of non-pharmacological strategies and their evidence base
• Understand the role of interventional analgesia such as regional blocks and intrathecal opioid pumps in the management of complex cancer pain.