Cancer pain management.

BACKGROUND Controlling pain in cancer patients is often inadequate. A recent multicenter study of patients with metastatic disease who were experiencing pain reported that 36% still had pain severe enough to compromise their daily function. METHODS The author draws on his experiences as well as those of others to review general guidelines and provide specific recommendations for cancer pain management. RESULTS Three components are critical to managing cancer pain: assessing pain, establishing an appropriate therapeutic opioid regimen, and integrating with other therapies. An appropriate therapeutic opioid regimen involves initiating, consolidating and maintaining therapy. Other strategies (e.g., advanced pharmacological, adjuvant, interventional, and psychological) can be added to opioid therapy. CONCLUSIONS A revision of the Agency for Health Care Policy and Research Cancer Pain Guidelines is currently underway. The management of pain in cancer patients should include more frequent reassessment of both analgesia and side effects to ensure optimal cancer pain relief.