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Eduardo Bruera, MD; Hak Nam Kim, MD

JAMA. 2003;290:2476-2479.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

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.³ An understanding of the mechanism of the pain . . . [Full Text of this Article]

Management

Pharmacological Management

Adjuvant Drugs

Nonpharmacological Treatment

Conclusion

Author Affiliation: Department of Palliative Care and Rehabilitation Medicine, University of Texas M. D. Anderson Cancer Center, Houston, Tex.

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