An Overview of Current Recommendations and Options for the Management of Cancer Pain: A Comprehensive Review
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REVIEW
An Overview of Current Recommendations and Options for the Management of Cancer Pain: A Comprehensive Review Kyle L. Gress
. Karina Charipova . Alan D. Kaye . Omar Viswanath .
Ivan Urits
Received: August 4, 2020 Ó The Author(s) 2020
ABSTRACT It is estimated that one-third of oncologic patients in the USA do not receive analgesia proportional to or adequate for the intensity of their pain. A mechanism-based approach to oncologic pain therapy is critical to ensure that analgesia regimens are individualized and effective. Since the mechanisms that lead to cancer pain are complex, healthcare providers must be willing to elicit and recognize the symptoms of each individual patient since these factors influence both the experience of pain
and response to treatment. This process is centered on the use of detailed history in order to understand symptom expression in the context of primary tumor diagnosis and progression, history of cancer pain, psychological distress, sleep disturbances, cognitive function, and addictive behavior. Incorporating all of these factors into the assessment of a patient’s pain condition can facilitate management decisions and help predict patient response to treatment.
Keywords: Cancer pain; Chronic Neoplasms; Opioids; Pain management
pain;
Digital Features To view digital features for this article go to https://doi.org/10.6084/m9.figshare.12860123. K. L. Gress (&) K. Charipova Georgetown University School of Medicine, Washington, DC, USA e-mail: [email protected] A. D. Kaye O. Viswanath Department of Anesthesiology, Louisiana State University Health Shreveport, Shreveport, LA, USA O. Viswanath Department of Anesthesiology, Creighton University School of Medicine, Omaha, NE, USA
O. Viswanath Valley Pain Consultants–Envision Physician Services, Phoenix, AZ, USA O. Viswanath Department of Anesthesiology, University of Arizona College of Medicine–Phoenix, Phoenix, AZ, USA I. Urits Department of Anesthesiology, Critical Care, and Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
Oncol Ther
Key Summary Points While the prevalence of cancer is increasing secondary, in part due to the advent of new diagnostic techniques, the incidence of cancer pain does not seem to be decreasing despite progress in the development of targeted cancer therapies. Assessments of cancer pain must be multifactorial and patient-centered; treatment is largely dependent on pharmacotherapy. Future research should utilize patientreported outcome measurements to drive the improvement of assessment tools and the development of new treatment options for the management of cancer pain, including neuraxial anesthesia and neuroablative techniques.
DIGITAL FEATURES This article is published with digital features to facilitate understanding of the article. To view digital features for this article go to https://doi. org/10.6084/m9.figshare.12860123.
INTRODUCTION Pain is one of the most common symptoms endorsed by cancer patients, especially those with metastatic dise
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