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Feature Article

Cancer pain management

Melanie Lovell, Frances M Boyle

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An updated version is available in the linked supplement

Abstract

Pain is one of the most feared and debilitating symptoms of cancer. Cancer pain can be controlled in most patients with strategies that are available in the community. Correcting misconceptions about opioids and providing comprehensive assessment and pain management, can improve affected patients’ quality of life.

Key Points

  • Cancer pain can be controlled in the majority of patients.
  • Cancer pain is common and screening for pain should be performed at each patient visit.
  • Strong opioids with paracetamol are first-line management in all patients with moderate to severe cancer pain.
  • When opioids are used to treat patients with cancer pain, addiction and clinically significant tolerance are rare.
  • Misconceptions regarding opioids are common, so all patients benefit from education when commencing opioids.
  • Adverse effects of opioids can be prevented or effectively managed.
  • Anticancer treatment, adjuvant therapy, nonpharmacological treatments and addressing psychosocial issues are all important elements of pain management.

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