Wednesday, November 12, 2003

Eduardo Bruera, MD; Hak Nam Kim, MD

INTRODUCTION

Approximately 1 in 3 individuals in the developed world will be diagnosed with cancer and half of those patients will die of progressive disease.1 More than 80% of patients with cancer develop pain before death.2 Pain is consistently one of the most feared consequences of cancer for both patients and families. Major improvements in the management of cancer pain in recent years include better assessment of pain, recognition and treatment of opioid-induced neurotoxicity, and the emerging use of opioid rotation and of methadone.


Assessment

In approximately two thirds of patients with cancer, pain is directly related to the presence of primary or metastatic disease3; another third of patients with cancer develop pain syndromes because of treatment, including sequelae of surgery, radiation, or chemotherapy, and other related causes such as osteoporosis, immobility, and infections.