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Cover of Management of Cancer Pain

Management of Cancer Pain

AHCPR Clinical Practice Guidelines, No. 9

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Rockville (MD): Agency for Health Care Policy and Research (AHCPR); .
Report No.: 94-0592

Cancer is diagnosed in over one million Americans annually, and one of five deaths in the United States about 1,400 per day result from cancer. Despite recent advances in the understanding of pain and pain management approaches, pain control remains a significant problem for patients with cancer. This guideline is designed to help any clinician who works with any oncology patient in any setting to understand the assessment and treatment of pain and associated symptoms.

The guideline was developed by an interdisciplinary panel of clinicians, patients, and experts in health policy. The panel used a combination of scientific evidence and expert judgment to make recommendations about pain management in patients with cancer.

The guideline makes recommendations about the assessment and management of pain. Interventions described include the use of (1) analgesics and adjuvant drugs; (2) cognitive/behavior strategies; (3) physical modalities; (4) palliative radiation and antineoplastic therapies; (5) nerve blocks; and (6) palliative and ablative surgery.

The cost of cancer pain in suffering, disability, and quality of life is high. The guidelines recommend that cancer pain be treated aggressively by pharmacologic and nonpharmacologic approaches. In most instances, pain can be treated effectively with relatively low-cost, noninvasive therapies. Given this evidence, health system barriers that interfere with effective pain management -- such as restrictive legislation regarding the uses of opioid analgesics and third-party payer practices that do not reimburse for less invasive interventions -- should be changed.

Contents

Suggested citation:

Jacox A, Carr DB, Payne R, et al. Management of Cancer Pain. Clinical Practice Guideline No. 9. AHCPR Publication No. 94-0592. Rockville, MD. Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service, March 1994.

Bookshelf ID: NBK52307
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