INTRODUCTION: Pain associated with advanced oncological disease occurs at different stages of the disease. When left unalleviated, it can generate physical, emotional, social, and spiritual symptoms, damage cognitive functions, activities of daily living and sleep, and cause general discomfort, defined by Cicely Saunders as "total pain".

MATERIALS AND METHODS: Literature narrative review on PubMed, Cochrane and CINAHL. The review was based on the steps and processes reported by the PRISMA standards for systematic reviews. The authors followed these steps: selection of the guiding question; definition of eligibility criteria; definition of relevant information from studies; evaluation of results; interpretation; summary of the information found. Limits: review, last ten years, human > 18 y/o. After this, due to the lack of results in finding, studies of lesser reliability were also included (like clinical trial and case report). Articles older than 10 years worthy of interest have been selected. 900 articles were identified, of which 880 were excluded for not meeting the pre-established inclusion criteria and another 10 studies were excluded after the full reading. Therefore, 10 articles were included in the final sample of this review.

RESULTS: Some studies analyzed used multidimensional tools aimed at a more complete evaluation, for example the Brief Pain Inventory, the Palliative Outcome Scale (POS2) and the Edmonton Symptom Assessment System (ESAS), with semi-structured interviews and one-dimensional instruments, such as the Visual Analog Scale (VAS). Pain and symptoms should be assessed according to each patient's characteristics, and this information should be recorded and available to all team members. Healthcare professionals need to be attentive to patients' symptoms and pain, adopting a holistic view that goes beyond drug treatment. A multiprofessional pain management team is needed, with which the nurse must interface regularly, which allows the treatment of every side of total pain, including psychological and social, to protect the ethics of care. A multidisciplinary approach can effectively relieve severe pain by providing multimodal treatment, detecting, and managing treatment side effects, and addressing underlying psychosocial distress. Spiritual support in pain management can contribute to pain reduction, assisting drug treatment and promoting the quality of life of cancer patients.

CONCLUSIONS: The included studies highlighted the importance of nurse communication with the multiprofessional team (important in planning and care) for pain management of people with cancer and the importance of assessing pain in various contexts. Understanding their state of health, a good relationship with professionals, and recognition of their suffering significantly improve perceived symptoms and distress.
Since total pain is a symptom involving various aspects of the human being, an approach involving the combined management of pain, symptoms and emotional distress is needed to alleviate the suffering of these people. Pain assessment of people in palliative care should be done simply and satisfactorily, with the aim of clearly understanding the date of onset, duration and level of pain and associated factors. The implementation of protocols and PDTA for an integrated treatment of total pain, even outside the palliative care environment, should be considered.