Current approaches to the management of cancer pain: A review Journal Article


Authors: Cherny, N. I.; Foley, K. M.
Article Title: Current approaches to the management of cancer pain: A review
Abstract: Pain, which is among the most prevalent symptoms experienced by cancer patients, can be effectively treated. Ratient assessment, the use of anticancer therapies and systemically administered non-opioid and opioid analgesics are pivotal. Practical aspects of opioid pharmacology include both drug selection, methods of analgesic administration: selection of the appropriate route, dose titration, and an understanding of the management of side effects. Specific approaches for the management of patients unable to attain an acceptable balance between relief and side effects of opioids are described. These comprise non-invasive interventions, including the use of adjuvant analgesics, psychological therapies and physiatric techniques, and invasive interventions, such as the use of intraspinal opioids, neural blockade and neuroablative techniques. Finally, the use of sedation in the management of patients with pain that is refractory to other inteventions is addressed. This approach can provide adequate relief to the vast majority of patients, most of whom will respond to systemic pharmacotherapy alone. Patients with refractory pain should have access to specialists in pain management or palliative medicine to address these difficult problems.
Keywords: review; neoplasms; unindexed drug; pain; drug administration schedule; opiate; sedation; cancer pain; chronic disease; pethidine; severity of illness index; acetylsalicylic acid; paracetamol; ibuprofen; naproxen; nonsteroid antiinflammatory agent; sulindac; clinical protocols; antidepressant agent; opioids; methadone; morphine; pain measurement; analgesics; anticonvulsive agent; behavior therapy; hydromorphone; analgesia, epidural; acute disease; analgesic agent; fentanyl; diamorphine; levorphanol; local anesthetic agent; oxycodone; nerve block; codeine; oxymorphone; pentazocine; buprenorphine; dextropropoxyphene; nalbuphine; flurbiprofen; ketoprofen; physical therapy techniques; butorphanol; human; support, u.s. gov't, p.h.s.; adjuvant analgesics; dezocine; neural blockade; spinal opioids
Journal Title: Annals of the Academy of Medicine, Singapore
Volume: 23
Issue: 2
ISSN: 0304-4602
Publisher: Academy Of Medicine Singapore  
Date Published: 1994-03-01
Start Page: 139
End Page: 159
Language: English
PUBMED: 8080220
PROVIDER: scopus
DOI/URL:
Notes: Review -- Export Date: 1 February 2019 -- Source: Scopus
Citation Impact
MSK Authors
  1. Kathleen M Foley
    163 Foley
  2. Nathan I. Cherny
    11 Cherny
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