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Delirium as a contributing factor to "crescendo" pain: three case reports
N Coyle1, W Breitbart, S Weaver
1Pain Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, New York 10021.
Journal of Pain and Symptom Management
|January 1, 1994
Summary
Cancer patients may experience escalating pain, known as crescendo pain, which can be difficult to manage. Delirium is an often overlooked cause of this severe pain pattern in cancer patients.
Area of Science:
- Oncology
- Geriatrics
- Palliative Care
Background:
- Cancer patients frequently experience severe pain episodes, termed crescendo pain.
- Assessing and managing crescendo pain presents significant clinical challenges.
- The etiology of crescendo pain is often multifactorial, extending beyond tumor progression.
Observation:
- Delirium is a common yet frequently underdiagnosed condition in cancer patients.
- Delirium can manifest with fluctuating cognitive and behavioral symptoms.
- This study highlights three cases linking delirium to crescendo pain patterns.
Findings:
- Delirium can significantly contribute to or exacerbate crescendo pain in cancer patients.
- Identifying delirium is crucial for effective pain management strategies.
- The presented cases demonstrate a clear association between delirium and escalating cancer pain.
Implications:
- Clinicians should consider delirium as a potential cause of crescendo pain in oncology settings.
- Screening for delirium may improve pain assessment and treatment outcomes.
- Integrating delirium management into palliative care can enhance patient quality of life.