Institute of Genetics and Cancer

Cancer patients’ pain can be eased by simple bedside chart

Patients with cancer could benefit from a new approach to manage their pain: March 2018


Using a simple bedside system reduces pain levels compared with conventional care, research with patients has shown.

People with cancer experience pain, and for 80% of those with advanced cancer, this has physical and emotional impacts on patients.

Researchers within the Palliative and Supportive Care Group of CRUK Edinburgh Centre the worked with doctors to develop the Edinburgh Pain Assessment and management Tool (EPAT) – a pen and paper chart where medical staff regularly record pain levels using a simple traffic light system.

Amber or red pain levels, indicating moderate or severe pain, prompts doctors to review patients’ medications and side effects and to monitor their pain more closely.

The trial looked at pain levels in almost 2,000 cancer patients over five days, following admission to regional cancer centres.

Patients whose care included use of the EPAT chart reported less pain during this time, compared with patients with standard care, who did not show an improvement.

Importantly, use of the chart was not linked to higher medicine doses. Authors suggest that it works by encouraging doctors to ask the right questions and to reflect on pain medications and side effects more frequently, before patients reach a crisis point.

Researchers say the system is a simple way to put pain management at the forefront of routine care, but caution that more studies are needed to understand how it could work longer term. The study was published in the Journal of Clinical Oncology and was funded by Cancer Research UK.

Professor Marie Fallon, of the Palliative and Supportive Care Group at the MRC IGMM, University of Edinburgh, said: “These exciting findings show the important benefits of influencing doctors’ behaviours, rather than looking for more complex and expensive interventions. These findings are a positive step towards reducing the burden of pain for patients and making them as comfortable as possible at all stages of cancer.”

Martin Ledwick, Head Information Nurse at Cancer Research UK, said: “In most cases it should be possible for cancer pain to be controlled if it is assessed and managed effectively. Any work that encourages medical teams to assess and monitor pain more carefully to help this happen has to be a good thing for patients.”

“The newly trialled Edinburgh Pain Assessment and management Tool (EPAT) has generated significant national and global media and press interest, with radio, newspaper and online coverage.”