Cancer pain management: Current strategy Conference Paper

Authors: Cherny, N. I.; Portenoy, R. K.
Title: Cancer pain management: Current strategy
Conference Title: 2nd International Conference on New Oncologic Agents: Practical Applications
Abstract: Pain is among the most prevalent symptoms experienced by cancer patients. A strategy for the management of cancer pain is now widely accepted, and when well implemented, is usually effective. Unfortunately, many oncologists are ill‐prepared for the task of pain assessment and management, and the outcomes achieved in clinical practice are often suboptimal. The various elements in the pain management strategy are described. Patient assessment, the use of primary therapies and systemically administered nonopioid and opioid analgesics are pivotal to the strategy. Practical aspects of opioid pharmacotherapy encompass drug selection and dosing considerations including selection of an appropriate route of administration, dose titration, and the management of side effects. Specific approaches are described for the treatment of patients for whom an acceptable balance between relief and side effects of opioids is not achieved. These comprise noninvasive 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 treatment of patients with pain that is refractory to other interventions is addressed. The skilled application of this strategy can provide adequate relief to the vast majority of patients, most of whom will respond to systemic pharmacotherapy alone. Patients with refractory pain should see specialists in pain management or palliative medicine who can address these difficult problems. Copyright © 1993 American Cancer Society
Keywords: drug efficacy; conference paper; neoplasms; cancer palliative therapy; medical decision making; pain; gastrointestinal symptom; sedation; cancer pain; paracetamol; nonsteroid antiinflammatory agent; regional perfusion; neuroleptic agent; antiemetic agent; opioids; drug half life; respiration depression; analgesics, opioid; pain measurement; analgesics; anticonvulsive agent; pain assessment; morphine sulfate; dose calculation; naloxone; pain management; drug formulation; oral drug administration; bleeding tendency; acetic acid derivative; intramuscular drug administration; sedative agent; docusate sodium; opiate antagonist; anesthetic agent; laxative; samarium 153; strontium 89; subcutaneous drug administration; opiate agonist; rhenium 186; intracerebroventricular drug administration; propionic acid derivative; salicylic acid derivative; human; priority journal; piroxicam; etodolac; nabumetone; intrathecal drug administration; mefenamic acid; adjuvant analgesics; neural blockade; spinal opioids
Journal Title Cancer
Volume: 72
Issue: 11 Suppl.
Conference Dates: 1993 Feb 4-6
Conference Location: San Diego, CA
ISBN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 1993-12-01
Start Page: 3393
End Page: 3415
Language: English
DOI: 10.1002/1097-0142(19931201)72:11+<3393::Aid-cncr2820721606>3.0.Co;2-o
PUBMED: 7902204
PROVIDER: scopus
Notes: Source: Scopus
Citation Impact
MSK Authors
  1. Russell K. Portenoy
    151 Portenoy
  2. Nathan I. Cherny
    11 Cherny
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