Cancer pain management

Clinical Practice Guideline, Cancer Pain Management. United States Department of Health and Human Services, Agency for Health Care Policy and Research. AHCPR Pub. Rockville, MD 1994. Available at http //www.ncbi.nlm.nih.gov/books/bookres.fcgi/ hstat6/07 capcf4.gif.Accessed January 10, 2006. 

Jadad, A.R. and Browman, G.P. The WHO analgesic ladder for cancer pain management. Stepping up the quality of its evaluation, JAMA 1995, 274, 1870-1873. 

Coluzzi, P.H. Cancer pain management newer perspectives on opioids and episodic pain, Am. J. Hosp. Palliat. Care 1998, 15, 13-22. 

The role of opioid rotation in cancer pain management has been described, highlighting the limitations of equianalgesic tablets and the need for monitoring and individualization of dose. This is particularly important when methadone is used as the opioid for conversion. The authors referred to a greater than expected potency of methadone, with excessive sedation and opioid-related adverse effects, if the switch is done on a one-to-one basis. They suggested that the calculated equianalgesic dose of methadone should be reduced by 75-90% and the dose then titrated upwards if necessary (47,48). 

Ayonrinde OT, Bridge DT. The rediscovery of methadone for cancer pain management. Med J Aust 2000 173(10) 536-40. 

Rischer JB, Childress SB. Cancer pain management pilot implementation of... 

Under controlled conditions, transdermal fentanyl is a useful option for direct conversion from mild to strong opioids in cancer patients. In addition, 25 pg/hour daily incremental steps of transdermal fentanyl can be made by palliative care specialists, if it is required for cancer pain management (59). 

The role of opioid rotation in cancer pain management has been described, highlighting the limitations of equianalgesic tablets and the need for monitoring and individualization of dose. This is particularly important... 

Donnelly S, Davis MP, Walsh D, Naughton M World Health Organization. Morphine in cancer pain management a practical guide. Support Care Cancer 2002 10(l) 13-35. 

Lauretti GR, Lima IC, Reis MP, Prado WA, Pereira NL. Oral ketamine and transdermal nitroglycerin as analgesic adjuvants to oral morphine therapy for cancer pain management. Anesthesiology 1999 90(6) 1528-33. 

This publication was groundbreaking, not only in its discussion of the lack of appropriate cancer pain management worldwide, but in its overall recommendations for managing cancer pain. The concept of the three-step analgesic ladder is introduced, which divides pain ratings into three categories mild, moderate, or severe, with medication selection based on a step-up approach. When this step approach to pain management is employed, up to 90% of all cancer pain can be relieved. 

Ten years after the original publication, an updated version of Cancer Pain Relief was published. The update included information from the 1989 publication, as well as any new advances in the management of cancer pain. This publication also included sections on the availability of opioids worldwide and the regulation of health care workers. Even though these publications are specific to cancer pain management, the basic principles can be applied to all chronic pain conditions. 

Numerous other publications are available in the area of cancer pain management. The AHCPR guide-... 

Recently, the National Comprehensive Cancer Network (NCCN) published their practice guidelines for cancer pain. This publication has numerous useful figures and tables outlining the process for cancer pain management and serves as an update to the 1994 AHCPR... 

Elliott, T.E. Murrary, D.M. Elliott, B.M. Braun, B. Oken, M.M. Johnson, K.M. Post-White, J. Lichtblau, L. Physician knowledge and attitudes about cancer pain management A survey from the Minnesota Cancer Pain Project. J. Pain Symptom Manage. 1995, 10 (7), 494-504. 

Bressler, L.R. Geraci, M.C. Feinberg, W.J. Pharmacists attitudes and dispensing patterns for opioids in cancer pain management. J. Pain Symptom Manage. 1995, 3 (2), 5-20. 

Doucette, W.R. Mays-Holland, T. Memmott, H. Lip-man, A.G. Cancer pain management Pharmacist knowledge and practices. J. Pain Symptom Manage. 1997, J (3), 17-31. 

Furstenberg, C.T. Ahles, T.A. Whedon, M.B. Pierce, K.L. Dolan, M. Roberts, L. Silberfarb, P.M. Knowledge and attitudes of health-care providers toward cancer pain management A comparison of physicians, nurses, and pharmacists in the state of New Hampshire. J. Pain Symptom Manage. 1998,15 (6), 335-349. 

Cleary, J.F. Cancer pain management. Cancer Control... 

Lothian, S.T. Fotis, M.A. von Gunten, C.F. Lyons, J. von Roenn, J.H. Weitzman, S.A. Cancer pain management through a pharmacist-based analgesic dosing service. Am. J. Health-Syst. Pharm. 1999, 56, 1119-1125, (June 1). 

Modalities of Cancer Pain Therapy 233 Interventional Computed Tomography Techniques in Cancer Pain Management 234 Regional Analgesia with Neurolytic Block 234 Neurolytic Block of Spinal Nerve 234 Sympathetic Chain Block 236 Management of Pain Syndromes Associated with Direct Tumor Involvement 242 Percutaneous Cementoplasty ... 

Interventional Computed Tomography Techniques in Cancer Pain Management... 

Portenoy RK (1993) Cancer pain management. Semin Oncol 20 19-35... 

Lucas L, Lipman A. Recent advances in pharmacotherapy for cancer pain management. 

Lussier D, Huskey A, Portenoy R. Adjuvant analgesics in cancer pain management. Oncologist 2004 9 571-591. 

Farquhar-Smith WP. Do cannabinoids have a role in cancer pain management Curr Opin Support Palliat C re 2009 3 7-13. 

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