Feature Article

Pain in advanced cancer. Next steps in successful pain management

Feature Article

Pain in advanced cancer. Next steps in successful pain management

JONATHAN RAMACHENDERAN, KIRSTEN AURET

Figures

© katarzynabialaslewic/ istockphoto.com models used for illustrative purposes only
© katarzynabialaslewic/ istockphoto.com models used for illustrative purposes only

Abstract

Pain in advanced disease is a multidimensional experience that can significantly impact on quality of life. Although pharmacotherapies are the cornerstone of managing pain in advanced cancer, other biological and nonpharmacological therapies can be used in conjunction to further relieve pain. A multidisciplinary and holistic approach that encompasses nonpharmacological and pharmacological therapies can enhance pain relief in patients with advanced cancer.

Key Points

  • Pain is a dynamic and multidimensional experience that is best treated using social-psychological-spiritual-biological management strategies.
  • Psychosocial and spiritual distress can worsen a patient’s experience of pain, and addressing these are key factors in successful pain management.
  • Multimodal therapy is the mainstay of pharmacological pain management in advanced cancer.
  • Pre-existing organ dysfunction, medication side-effect profile and patient social and psychological factors must be considered when selecting pharmacological therapies.