Cancer pain

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By K K Jain MD

Pain is a common, undertreated problem in cancer patients. The ideal management of a patient with cancer pain is a multidisciplinary approach that includes oncology, neurology, anesthesia, nursing, psychology, and pharmacy. Opioids remain the cornerstone of pharmacotherapy for cancer pain, and various factors taken into consideration for the selection of an opioid include the severity of pain, the patient’s response to previous therapy, the drug's pharmacokinetics, and the available formulations. In the following clinical article, KK Jain MD, a neurology consultant in Basel, Switzerland, reviews the evaluation of pain as a symptom of cancer and discusses the pathophysiology, assessment, differential diagnosis, diagnostic workup, and general management of the condition.

Key points

  • Cancer pain is frequent and often undertreated.
  • The mainstay of breakthrough pain in cancer is use of adequate opioids with improved delivery.
  • Approximately 10% to 30% of patients with cancer pain require surgery, which may be directed at the cancer or may involve neurosurgical procedures for relief of pain.