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Adult Cancer-Related Pain

  • Sean Ransom
  • Timothy P. Pearman
  • Errol Philip
  • Dominique Anwar
Chapter

Abstract

Although prevalence estimates vary widely, pain is understood to be widespread among those with cancer, and, for many, such pain is undertreated. Cancer-related pain can be associated with a multitude of causes, courses, and treatments. World Health Organization (WHO) guidelines have helped reduce the burden of pain among those with cancer, with the WHO Cancer Pain Ladder providing a simple algorithm for pain treatment. Opioid treatment continues to be a mainstay of cancer-related pain, and modifications of the WHO Cancer Pain Ladder may be required when pain is severe. As with all pain, psychological factors play an important role in cancer-related pain, with emotional distress, cognitive coping strategies like catastrophizing, and pain-related behaviors shown as important predictors of pain severity. Because of this, psychological and behavioral treatments have shown effectiveness in reducing cancer pain burden. Barriers to effective pain management include psychological barriers, such as a fear of opioid addiction, social variables, such as discriminatory patterns of prescribing, or cultural variables, such as a cultural emphasis on stoicism in the face of pain. As cancer develops into its advanced stages, pain management may move to the forefront of patient care. Palliative care programs are among the most effective approaches to reducing the undertreatment of cancer-related pain and are proven to increase patient quality of life while reducing healthcare costs. Unfortunately, inaccurate perceptions among both patients and physicians of palliative care as being for patients without hope continue to persist. Perceptions of palliative care, however, are beginning to change and the future of cancer treatment will likely see a greater multi-disciplinary and multi-specialty focus on the treatment of pain. Innovations such as patient navigation will also likely result in increased pain management and reduced ethnic disparities.

Keywords

Palliative Care Neuropathic Pain Pain Management National Comprehensive Cancer Network Cancer Pain 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science+Business Media, LLC 2013

Authors and Affiliations

  • Sean Ransom
    • 1
    • 2
  • Timothy P. Pearman
    • 3
    • 4
  • Errol Philip
    • 5
  • Dominique Anwar
    • 6
  1. 1.Department of Psychiatry and Behavioral SciencesTulane University School of MedicineNew OrleansUSA
  2. 2.Tulane University Medical Center, Tulane Cancer CenterNew OrleansUSA
  3. 3.Departments of Medical Social Sciences and PsychiatryNorthwestern University Feinberg School of MedicineChicagoUSA
  4. 4.Department of Supportive OncologyRobert H. Lurie Comprehensive Cancer CenterChicagoUSA
  5. 5.Department of Psychiatry and Behavioral SciencesMemorial Sloan-Kettering Cancer CenterNew YorkUSA
  6. 6.Department of Medicine, Section of General Internal Medicine and GeriatricsTulane University School of MedicineNew OrleansUSA

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