Abstract
Cancer pain is one of the most dreadful types of pain experienced by the patients and difficult one to treat by the pain physicians; 60–80% cancer pain is inadequately treated, 40% dies with severe pain. But multimodal, multidisciplinary management can cure more than 90% of cancer pain. Barriers of pain management are lack of awareness of health workers, medical personals, policy makers, and public, lack of infrastructure as compared to the growing number of cancer patients, fear of drug abuse/dependency of the patients, and nonavailability of opioid due to legal restrictions. Various validated scales are used for qualitative and quantitative assessment of cancer pain. History, clinical examinations, and relevant imaging are used for diagnosis. Treatment is done following WHO Analgesic ladder. In severe cancer pain, interventional procedures are considered to relieve pain and to improve the quality of life. Advanced interventional procedures (e.g., spinal cord stimulators, vertebroplasty, and balloon kyphoplasty) and neurosurgical palliative techniques (e.g., commissural myelotomy and percutaneous cordotomy) are considered in advanced cancer with excruciating pain. Cognitive-behavioral therapy, hypnosis, relaxation therapy, physical therapy, and psychological counseling are the adjuvant therapy techniques. Palliative care begins at any point along the cancer care continuum, extended even after death of the patient. Hospice-based, home-based cancer pain management and respite care are given in final days of life.
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Goswami, S., Ghosh, D., Nandi, G., Mukherjee, S., Sarkar, B. (2022). Pain Management in Oncology. In: Basu, S.K., Panda, C.K., Goswami, S. (eds) Cancer Diagnostics and Therapeutics . Springer, Singapore. https://doi.org/10.1007/978-981-16-4752-9_15
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