The management of cancer pain

Abstract

(CA Cancer J Clin 2000;50: 70-116.) Pain is among the most prevalent symptoms experienced by patients with cancer.1 The success of cancer pain therapy-which depends on the ability of the clinician to assess the presenting problems, identify and evaluate pain syndromes, and formulate a plan for comprehensive continuing care-requires familiarity with a range of therapeutic options (Table 1) and an approach to longterm care that is responsive to the changing needs of the patient.The formulation of an effective therapeutic strategy for the management of pain and other symptoms is predicated on a comprehensive assessment of the patient. Such an assessment should clarify the characteristics of the pain, including its impact on function and psychological well-being; identify the pain syndrome and the putative mechanisms that may underlie the pain; define and evaluate both the nature and extent of the underlying disease; and characterize concurrent problems (physical, psychological, and social) that are contributing, or may soon contribute, to patient distress.The particular therapeutic strategy that evolves from this information depends on the goals of care. These goals can generally be grouped into three broad categories: 1) Prolonging survival, 2) optimizing comfort, and 3) optimizing function. The relative priority of these goals provides an essential context for t h e m a n a g e m e n t o f c a n c e r p a i n 70Ca-A cancer Journal for Clinicians

Assessing and Treating Pain in Hospices: Current State of Evidence-Based Practices

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Efficacy of Chronic Morphine in a Rat Model of Cancer-Induced Bone Pain: Behavior and in Dorsal Horn Pathophysiology

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