2.7.3 Patients with Cancer-Related Pain and Patients in Palliative Care

Cancer pain affects millions of Americans.306,354 In addition, there are more than 14 million cancer survivors in the United States as a result of remarkable advances in cancer diagnosis and therapy. An estimated 40% of cancer survivors continue to experience persistent pain as a result of treatments such as surgery, chemotherapy, and radiation therapy.

Persistent pain is also common and significant in patients with a limited prognosis, as often encountered in hospice and palliative care environments.355

GAPS AND RECOMMENDATIONS

GAP 1: These patient populations are frequently managed by practitioners who do not specialize in pain or palliative care. Many oncologists and primary care physicians are not trained to recognize or treat persistent pain associated with cancer or other chronic medical problems with limited prognosis.

• RECOMMENDATION 1A: Clinicians should assess and address pain at each patient encounter. Causes of pain such as recurrent disease, second malignancy, or late-onset treatment effects should be evaluated, treated, and monitored.

GAP 2: Patients with persistent pain associated with cancer and/or cancer treatment or other chronic medical problems with limited prognosis in palliative care often receive less optimal care with restricted treatment modalities.

• RECOMMENDATION 2A: When clinically indicated, use multimodal and multidisciplinary treatment as part of cancer-related pain management and palliative care.

• U.S. Department of Health and Human Services (2019, May). Pain Management Best Practices Inter-Agency Task Force
  Report: Updates, Gaps, Inconsistencies, and Recommendations. Retrieved from U. S. Department of Health and Human
  Services

Cannabis and Cancer Pain

Additional Reading

• Afsharimani, B., Kindl, K., Good, P., & Hardy, J. (2015). Pharmacological options for the management of refractory cancer pain—what is the evidence?. Supportive Care in Cancer, 23(5), 1473-1481.

This session is not provided for CME credits.