Cancer pain Part 1: Pathophysiology; oncological, pharmacological, and psychological treatments: A perspective from the British pain society endorsed by the UK association of palliative medicine and the royal college of general practitioners: Cancer pain Part 1

Jon Raphael*, Sam Ahmedzai, Joan Hester, Catherine Urch, Janette Barrie, John Williams, Paul Farquhar-Smith, Marie Fallon, Peter Hoskin, Karen Robb, Michael I. Bennett, Rebecca Haines, Martin Johnson, Arun Bhaskar, Sam Chong, Rui Duarte, Elizabeth Sparkes

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

76 Citations (Scopus)

Abstract

Objective.: This discussion document about the management of cancer pain is written from the pain specialists' perspective in order to provoke thought and interest in a multimodal approach to the management of cancer pain, not just towards the end of life, but pain at diagnosis, as a consequence of cancer therapies, and in cancer survivors. It relates the science of pain to the clinical setting and explains the role of psychological, physical, interventional and complementary therapies in cancer pain. Methods.: This document has been produced by a consensus group of relevant health care professionals in the United Kingdom and patients' representatives making reference to the current body of evidence relating to cancer pain. In the first of two parts, pathophysiology, oncological, pharmacological, and psychological treatment are considered. Conclusions.: It is recognized that the World Health Organization (WHO) analgesic ladder, while providing relief of cancer pain towards the end of life for many sufferers worldwide, may have limitations in the context of longer survival and increasing disease complexity. To complement this, it is suggested that a more comprehensive model of managing cancer pain is needed that is mechanism-based and multimodal, using combination therapies including interventions where appropriate, tailored to the needs of an individual, with the aim to optimize pain relief with minimization of adverse effects. Wiley Periodicals, Inc.

Original languageEnglish
Pages (from-to)742-764
Number of pages23
JournalPain Medicine
Volume11
Issue number5
DOIs
Publication statusPublished - 2010
Externally publishedYes

Keywords

  • Neoplasms
  • Pain
  • Palliative Care
  • Therapeutics

ASJC Scopus subject areas

  • Clinical Neurology
  • Anesthesiology and Pain Medicine
  • General Medicine

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