Pain management improves the patient's quality of life throughout all stages of the disease. State and local laws often restrict the medical use of opioids to relieve cancer pain, and third-party payers may not reimburse for noninvasive pain control treatments. Thus, clinicians should work with regulators, state cancer pain initiatives, or other groups to eliminate these health care system barriers to effective pain management. Table 1 lists these and other barriers to effective pain management. Changes in health care delivery may create additional disincentives for clinicians to practice effective pain management.
Flexibility is the key to managing cancer pain.
As patients vary in diagnosis, stage of disease, responses to pain and interventions, and personal preferences, so must pain management. Figure 1 emphasizes that the recommended clinical approach focuses on patient involvement. Highlights of patient management Effective pain management is best achieved by a team approach involving patients, their families, and health care providers. Figure 2 shows the sequence of activities related to pain assessment and management. The flowchart emphasizes the use of multiple modalities concurrently, beginning treatment with the least invasive modalities, and advancing treatment to meet the patient's need for pain relief.