Cancer pain management

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.

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LONGTERM EPIDURAL ANALGESIA FOR PANCREATIC CANCER PAIN MANAGEMENT AS ALTERNATIVE TECHNIQUE TO IMPROVE QUALITY OF LIFE – A SERIAL CASE REPORT

10.26226/morressier.598b05d9d462b80290b53a73 ◽

2017 ◽

Author(s):

Bambang Pujo Semedi

Keyword(s):

Quality Of Life ◽

Pancreatic Cancer ◽

Case Report ◽

Pain Management ◽

Epidural Analgesia ◽

Cancer Pain ◽

Alternative Technique ◽

Improve Quality ◽

Cancer Pain Management

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Pain management

Oxford Textbook of Medicine ◽

10.1093/med/9780198746690.003.0064 ◽

2020 ◽

pp. 629-633

Author(s):

Marie Fallon

Keyword(s):

Quality Of Life ◽

Pain Management ◽

Pain Relief ◽

Adverse Effects ◽

Cancer Pain ◽

Daily Functioning ◽

Opioid Analgesia ◽

Patients With Cancer ◽

Good Pain Relief

Pain occurs in more than 50% of patients with advanced disease, interferes with daily functioning and quality of life, and is very often undertreated. Patients can find it difficult to articulate the character of their pains, but it is important to determine whether it is somatic, neuropathic, or visceral since this has important implications for management. For most patients with cancer pain, a three-step approach combining simple or opioid analgesia (depending on severity) along with an adjuvant analgesic (depending on cause) will result in good pain relief, but the challenge is to achieve good pain relief without unacceptable adverse effects.

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Implementing Guidelines for Cancer Pain Management: Results of a Randomized Controlled Clinical Trial

Journal of Clinical Oncology ◽

10.1200/jco.1999.17.1.361 ◽

1999 ◽

Vol 17 (1) ◽

pp. 361-361 ◽

Cited By ~ 188

Author(s):

Stuart L. Du Pen ◽

Anna R. Du Pen ◽

Nayak Polissar ◽

Jennifer Hansberry ◽

Beth Miller Kraybill ◽

...

Keyword(s):

Quality Of Life ◽

Decision Making ◽

Pain Management ◽

Cancer Pain ◽

Symptom Management ◽

Controlled Study ◽

Cancer Pain Management ◽

Randomized Controlled ◽

Prospective Longitudinal

PURPOSE: Pain and symptom management is an integral part of the clinical practice of oncology. A number of guidelines have been developed to assist the clinician in optimizing comfort care. We implemented clinical guidelines for cancer pain management in the community setting and evaluated whether these guidelines improved care. PATIENTS AND METHODS: Eighty-one cancer patients, aged 37 to 76 years, were enrolled onto a prospective, longitudinal, randomized controlled study from the outpatient clinic settings of 26 western Washington–area medical oncologists. A multilevel treatment algorithm based on the Agency for Health Care Policy and Research Guidelines for Cancer Pain Management was compared with standard-practice (control) pain and symptom management therapies used by community oncologists. The primary outcome of interest was pain (Brief Pain Inventory); secondary outcomes of interest were all other symptoms (Memorial Symptom Assessment Scale) and quality of life (Functional Assessment of Cancer Therapy Scale). RESULTS: Patients randomized to the pain algorithm group achieved a statistically significant reduction in usual pain intensity, measured as slope scores, when compared with standard community practice (P < .02). Concurrent chemotherapy and patient adherence to treatment were significant mediators of worst pain. There were no significant differences in other symptoms or quality of life between the two treatment groups. CONCLUSION: This guideline implementation study supports the use of algorithmic decision making in the management of cancer pain. These findings suggest that comprehensive pain assessment and evidence-based analgesic decision-making processes do enhance usual pain outcomes.

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