Principles & Practice of Pain Medicine > Part V. Pain Syndromes > C. Pain in the Terminally Ill > Chapter 45. Medical Management of Cancer Pain Stuart W. Hough and Russell K. Portenoy

Overview

"Cancer pain is usually caused directly by neoplastic injury to pain-sensitive structures. For this reason, primary antineoplastic therapy, including radiation, chemotherapy, and palliative surgery, should be considered part of an analgesic strategy in some cases. When therapy directed at the tumor is inappropriate, is not feasible, or is ineffective, symptomatic analgesic therapies become the overriding concern. Opioid-based pharmacotherapy is the mainstay approach, but adjunctive anesthetic, surgical, psychiatric, and physical modalities may be essential in some cases (See Chapter 46, Anesthetic Interventions in Cancer Pain). Pharmacologic approaches may be systemic or regional (anesthetic). This chapter addresses only systemic pharmacologic analgesics...."