Barriers to pain management in the rehabilitation of the surgical oncology patient

Abstract

Virtually every surgical oncology patient faces pain, and it can become a major barrier to rehabilitation and quality of life. Pain must be assessed as to its severity, etiology (somatic, visceral, or neuropathic), causation (directly from malignancy or from treatment side effects), and its impact on daily function. Treatments can include physical modalities, exercise, opioids, adjuvant medications, and interventional techniques. Barriers to treatment may include side effects, finances, and attitudes. New technologies in medication delivery systems, intrathecal pumps, injections, and surgery have greatly strengthened the armamentarium available to manage pain.

Use of Opioid Analgesics Among Older Persons With Colorectal Cancer in Two Health Districts With Palliative Care Programs

“…Overall, these findings may reflect insufficient provider knowledge about pain assessment and treatment 32 or provider [33][34][35][36] and/or patient 37 fears about prescribing or using opioids ("opiophobia"). Indeed, a common misconception is that opioid use will hasten death through respiratory depression, 38 although there is little evidence to support this belief when the drugs are appropriately titrated.…”

Long-term effect of pulsed high-intensity laser therapy in the treatment of post-mastectomy pain syndrome: a double blind, placebo-control, randomized study

“…Their safety and efficacy are therefore not certain. However, those modalities that are generally believed to be safe include cryotherapy, biofeedback, iontophoresis, transcutaneous electrical nerve stimulation, and massage [12]. Applying modalities directly over tumor sites is done so with caution.…”

“…Applying modalities directly over tumor sites is done so with caution. Deep heat such as ultrasound or phonophoresis is typically contraindicated in cancer patients [12].…”

Supportive care for women with gynecologic cancers

“…Anticancer Ther. 8(2), (2008) Review Chase, Monk, Wenzel & Tewari suffer the consequences of not treating pain in order to avoid the side effects and addictive properties of opioids [3][4][5]. As pain may be associated with the original diagnosis, the patient may associate recurrence of disease with pain and may, therefore, be reluctant to report such symptoms.…”

“…As pain may be associated with the original diagnosis, the patient may associate recurrence of disease with pain and may, therefore, be reluctant to report such symptoms. This may lead to exacerbations and poor control in the chronic setting and poor management of cancer pain has been associated with decreased physical and emotional status [4,5,101]. Therefore, it is critical that pain should not be suffered and that significant attention to its management is paid in order to improve overall QoL.…”