The Guideline presents a thorough discussion of ways to manage procedure-induced pain and invasive modalities of pain control therapy, for use when simpler methods do not control pain. It also devotes considerable attention to pain control in special populations, including patients with concurrent medical and substance abuse problems, those with psychiatric problems related to pain and cancer, and members of minority and ethnic groups. Practitioners should review the Clinical Practice Guideline carefully to become familiar with the various options for management of cancer pain and then use the Quick Reference Guide to help them remember the major points in managing cancer pain. Unfortunately, pain associated with cancer is frequently undertreated. Although cancer pain or associated symptoms cannot always be entirely eliminated, appropriate use of available therapies can effectively relieve pain in the great majority of patients.
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.