Cancer Pain Management Methods

Regaard (2000) reports that of the symptoms experienced by people with advanced cancer, pain is the most feared. This fear is not groundless as the incidence of uncontrolled pain is high in groups of cancer patients (Gunnarsdottir, Donovan, Serlin, Voge & Ward, 2002). Thus, cancer patients need real help to manage their pain. Diverse methods of cancer pain management have been developed for cancer patients of all ages (Ellis, O'Connor, Cappelli, Goodman, Blouin & Reid, 2002). The purpose of this review of literature is to determine the basic types of cancer pain management and to look at research the efficacy of these methods.

Types of Interventions Used For Cancer Pain Management

The World Health Center (1999) issued a report on the basic methods of pain management, noting that health service providers must work with the patient and family members to decide which pain management methods to use. This decision should be based on such factors as the stage of the cancer, the patient's age, response to pain and personal likes and dislikes. WHO (1999) states that the most often used cancer pain management methods are:

(1) Medication - This involves pain management with drug therapy. For mild to moderate pain, the drugs are often aspirin, acetaminophen, or nonsteroidal anti-inflammatory drugs (NSAIDs). When discomfort lasts or increases, the doctor may add an opioid to aspirin, acetaminophen, or NSAIDS. If pain persists, the opioid potency or dose may be increased. Also, t

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noted that minorities, women, and the elderly may be at greater risk for under-treatment of pain. Several problems were also found for the quality of most of the research in the area. These were summarized in the report as follows: Survey data for the most part do not distinguish between different etiologies and mechanisms of cancer pain. Prevalence data imply that the number of patients enrolled in methodologically sound trials of cancer pain relief is a tiny fraction of those receiving care. Relatively few subjects are enrolled per trial, and the total number of published randomized controlled trials relative to patients under care is much lower than for nearly all other high-impact, costly conditions. (Agency for Healthcare Research and Quality, 2000, p.1). The Agency for Healthcare Research and Quality (2001) still formulates several conclusions about diverse pain management techniques based on available findings. The Agency notes that while the number of controlled trials evaluating analgesic drugs for cancer pain are small, there is evidence of an opioid dose-sparing effect from co-administration of an NSAID but no consistent reduction in side effects from co-administration. Studies that address the effectiveness of NSA

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