Pain in Advanced Cancer: Assessment and Management

OBJECTIVES After participating in the CME activity, primary care physicians should be able to: 1. Identify barriers to adequate pain management 2. Describe the key elements of pain assessment 3. Describe the principles of pharmacologic and nonpharmacologic management of cancer pain 4. Understand the approach to use of analgesic agents presented in the World Health Organization analgesic ladder 5. Discuss the role of methadone for the management of neuropathic pain in advanced cancer

[1]  S. Hassenbusch,et al.  NCCN Practice Guidelines for Cancer Pain. , 2000, Oncology.

[2]  S. T. Brown.  Outcomes analysis of a pain management project for two rural hospitals. , 2000, Journal of Nursing Care Quality.

[3]  C. Cleeland.  Cancer-related symptoms. , 2000, Seminars in radiation oncology.

[4]  Y. Lazorthes,et al.  Human chromaffin cell graft into the CSF for cancer pain management: a prospective phase II clinical study , 2000, Pain.

[5]  C. Cleeland,et al.  Minority cancer patients and their providers , 2000, Cancer.

[6]  D. Walsh,et al.  Clinical evaluation in advanced cancer. , 2000, Seminars in oncology.

[7]  A. Vallerand,et al.  Analysis of pain content in nursing textbooks. , 2000, Journal of pain and symptom management.

[8]  I. Byock.  Completing the continuum of cancer care: Integrating life‐prolongation and palliation , 2000, CA: a cancer journal for clinicians.

[9]  D. Walsh,et al.  Symptom control in advanced cancer: important drugs and routes of administration. , 2000, Seminars in oncology.

[10]  N. Hagen,et al.  Methadone: outpatient titration and monitoring strategies in cancer patients. , 1999, Journal of pain and symptom management.

[11]  E. Bruera,et al.  Reduction in constipation and laxative requirements following opioid rotation to methadone: a report of four cases. , 1999, Journal of pain and symptom management.

[12]  A. Adunsky,et al.  High dose morphine use in the hospice setting , 1999, Cancer.

[13]  S. Mercadante.  Costs are a further barrier to cancer pain management. , 1999, Journal of Pain and Symptom Management.

[14]  E. Zecca,et al.  Gabapentin as an adjuvant to opioid analgesia for neuropathic cancer pain. , 1999, Journal of pain and symptom management.

[15]  R. Portenoy,et al.  Management of cancer pain , 1999, The Lancet.

[16]  Sebastiano G. Mercadante.  When oral morphine fails in cancer pain: The role of the alternative routes , 1998, The American journal of hospice & palliative care.

[17]  K. Foley,et al.  Methadone in cancer pain management: individualize dose and titrate to effect. , 1998, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[18]  K. L. Lenz,et al.  Pain Management in the Cancer Patient , 1998 .

[19]  R. Busse,et al.  Sentinel practices in evaluating longer periods of care: quality of life and drug therapy of terminally ill persons in Lower Saxony (Germany). , 1998, Journal of epidemiology and community health.

[20]  S. Block,et al.  Palliative care in undergraduate medical education. Status report and future directions. , 1997, JAMA.

[21]  E. Zecca,et al.  An update on the clinical use of methadone for cancer pain , 1997, Pain.

[22]  H. J. McQuay,et al.  A systematic review of antidepressants in neuropathic pain , 1996, Pain.

[23]  S. Horowitz,et al.  Surgical Treatment of Pathologic Hip Lesions in Patients With Metastatic Disease , 1996, Clinical orthopaedics and related research.

[24]  M. Levy.  Pharmacologic treatment of cancer pain. , 1996, The New England journal of medicine.

[25]  E. Bruera,et al.  Opioid rotation in patients with cancer pain: A retrospective comparison of dose ratios between methadone, hydromorphone, and morphine , 1996, Cancer.

[26]  R. Depompolo,et al.  Focused review: postmastectomy lymphedema. , 1996, Archives of physical medicine and rehabilitation.

[27]  R. Portenoy.  Adjuvant analgesic agents. , 1996, Hematology/oncology clinics of North America.

[28]  W. Forman,et al.  Hospice and Palliative Care: Concepts and Practice , 1996 .

[29]  B. Ferrell,et al.  Unscheduled readmissions for uncontrolled symptoms. A health care challenge for nurses. , 1995, The Nursing clinics of North America.

[30]  B. Ferrell,et al.  The impact of pain on quality of life. A decade of research. , 1995, The Nursing clinics of North America.

[31]  Ferrell Br.  The impact of pain on quality of life. A decade of research. , 1995 .

[32]  B. Ferrell,et al.  Pain in cognitively impaired nursing home patients. , 1995, Journal of pain and symptom management.

[33]  Dawn Carroll,et al.  Anticonvulsant drugs for management of pain: a systematic review , 1995, BMJ.

[34]  D. Walsh,et al.  The symptoms of advanced cancer. , 1995, Seminars in oncology.

[35]  T. Hedner,et al.  Outcomes of epidural morphine treatment in cancer pain: nine years of clinical experience. , 1995, Journal of pain and symptom management.

[36]  S. Reddy,et al.  The neuroleptics as adjuvant analgesics. , 1994, Journal of pain and symptom management.

[37]  E. Bruera,et al.  Corticosteroids as adjuvant analgesics. , 1994, Journal of Pain and Symptom Management.

[38]  N. Cherny,et al.  The management of cancer pain , 1994, CA: a cancer journal for clinicians.

[39]  R. Portenoy,et al.  Sedation in the Management of Refractory Symptoms: Guidelines for Evaluation and Treatment , 1994, Journal of palliative care.

[40]  B. Ferrell,et al.  Cost issues related to pain management: report from the Cancer Pain Panel of the Agency for Health Care Policy and Research. , 1994, Journal of pain and symptom management.

[41]  C. Cleeland,et al.  Pain assessment: global use of the Brief Pain Inventory. , 1994, Annals of the Academy of Medicine, Singapore.

[42]  C. A. Hardin,et al.  Pelvic exenteration: a treatment for failed rectal cancer surgery. , 1993, The American surgeon.

[43]  W. Hanks,et al.  Cancer pain: management , 1992, The Lancet.

[44]  C. Akinsanya.  Cancer pain relief and palliative care , 1992 .

[45]  N. Coyle,et al.  Infection as a cause of rapidly increasing pain in cancer patients. , 1991, Journal of Pain and Symptom Management.

[46]  D. Spiegel,et al.  Pain Management in the Cancer Patient , 1989 .

[47]  S. I. Etzel,et al.  Undergraduate Medical Education , 1983 .

[48]  B. Liang.  Health law and policy : a survival guide to medicolegal issues for practitioners , 2000 .

[49]  D. Clegg,et al.  Selective COX-2 inhibition. , 1999, Bulletin of rheumatic diseases.

[50]  B. Trauger-Querry,et al.  Balancing the focus: art and music therapy for pain control and symptom management in hospice care. , 1999, The Hospice journal.

[51]  M. Mccaffery,et al.  Pain : clinical manual , 1999 .

[52]  D. Weissman.  A faculty development course for end-of-life care. , 1998, Journal of palliative medicine.

[53]  P. Fine,et al.  A review of oral transmucosal fentanyl citrate: potent, rapid and noninvasive opioid analgesia. , 1998, Journal of palliative medicine.

[54]  E. Bruera,et al.  Topics in palliative care , 1997 .

[55]  P Marcks,et al.  Lymphedema. Pathogenesis, prevention, and treatment. , 1997, Cancer practice.

[56]  Morton Rosenberg,et al.  Management of Cancer Pain, Clinical Practice Guideline No. 9. , 1996 .

[57]  M. Sweeney,et al.  Methadone: A Review of Its Use in Pain Management , 1996 .

[58]  H. Wanebo,et al.  Pelvic exenteration for recurrent rectal cancer. , 1996, Advances in surgery.

[59]  R. Twycross.  Pain relief in advanced cancer , 1994 .

[60]  L. Knodel.  Gastrointestinal toxicity of nonsteroidal antiinflammatory drugs , 1994 .

[61]  E. Silberstein,et al.  Phosphorus-32 radiopharmaceuticals for the treatment of painful osseous metastases. , 1992, Seminars in nuclear medicine.

[62]  N. Macdonald.  Palliative care--the fourth phase of cancer prevention. , 1991, Cancer detection and prevention.