Skip to main content Accessibility help
×
×
Home

The need for a multidisciplinary approach to pain management in advanced cancer: A clinical case

  • Neha Didwaniya (a1), Kimberson Tanco (a2), Maxine de la Cruz (a2) and Eduardo Bruera (a2)
Abstract

Advanced cancer patients are often affected by multiple complex symptoms brought about by persistent nociceptive stimuli and intense psychosocial distress. One such complex symptom, cancer pain, has continued to pose a challenge in medical management even though the concept of total pain was described several years ago by Cicely Saunders. Oftentimes, the application of a multidisciplinary approach is delayed after numerous opioid dose escalations and invasive procedures have been performed. The case presented here highlights the importance of timely multidisciplinary intervention and the use of an acute palliative care unit, which resulted in adequate pain control after multiple medical and invasive procedures that caused toxicities.

Copyright
Corresponding author
Address correspondence to: Kimberson Tanco, Department of Palliative Care and Rehabilitation Medicine, Unit 1414, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Houston, Texas 77030. E-mail: kctanco@mdanderson.org
References
Hide All
Ahles, T.A., Blanchard, E.B. & Ruckdeschel, J.C. (1983). The multidimensional nature of cancer-related pain. Pain, 17(3), 277288.
Archie, P., Bruera, E. & Cohen, L. (2013). Music-based interventions in palliative cancer care: A review of quantitative studies and neurobiological literature. Supportive Care in Cancer, 21(9), 116.
Basile, A., Masala, S., Banna, G., et al. (2012). Intrasomatic injection of corticosteroid followed by vertebroplasty increases early pain relief rather than vertebroplasty alone in vertebral bone neoplasms: Preliminary experience. Skeletal Radiology, 41(4), 459464.
Berenson, J., Pflugmacher, R., Jarzem, P., et al. (2011). Balloon kyphoplasty versus non-surgical fracture management for treatment of painful vertebral body compression fractures in patients with cancer: A multicentre, randomised controlled trial. Lancet, 12(3), 225235.
Bruera, E. & Watanabe, S. (1994). New developments in the assessment of pain in cancer patients. Supportive Care in Cancer, 2(5), 312318.
Casarett, D., Johnson, M., Smith, D., et al. (2011). The optimal delivery of palliative care: A national comparison of the outcomes of consultation teams vs. inpatient units. Archives of Internal Medicine, 171(7), 649655.
Cherny, N.I., Coyle, N. & Foley, K.M. (1994). Suffering in the advanced cancer patient: A definition and taxonomy. Journal of Palliative Care, 10(2), 5770.
Delgado-Guay, M., Parsons, H.A., Li, Z., et al. (2009). Symptom distress in advanced cancer patients with anxiety and depression in the palliative care setting. Supportive Care in Cancer, 17(5), 573579.
Elsayem, A., Calderon, B.B., Camarines, E.M., et al. (2011). A month in an acute palliative care unit: Clinical interventions and financial outcomes. American Journal of Hospice & Palliative Care, 28(8), 550555.
Ewing, J.A. (1984). Detecting alcoholism. The Journal of the American Medical Association, 252(14), 19051907.
Hanks, G.W., Conno, F., Cherny, N., et al. (2001). Morphine and alternative opioids in cancer pain: The EAPC recommendations. British Journal of Cancer, 84(5), 587593.
Hui, D., Elsayem, A., De La Cruz, M., et al. (2010). Availability and integration of palliative care at U.S. cancer centers. The Journal of the American Medical Association, 303(11), 10541061.
Kerr, C.W., Drake, J., Milch, R.A., et al. (2012). Effects of methylphenidate on fatigue and depression: A randomized, double-blind, placebo-controlled trial. Journal of Pain and Symptom Management, 43(1), 6877.
McCall, M.C., Ward, A., Roberts, N.W., et al. (2013). Overview of systematic reviews: Yoga as a therapeutic intervention for adults with acute and chronic health conditions. Evidence-Based Complementary and Alternative Medicine. Available from http://www.hindawi.com/journals/ecam/2013/945895/. Epub ahead of print.
McKiernan, F., Faciszewski, T. & Jensen, R. (2004). Quality of life following vertebroplasty. Journal of Bone and Joint Surgery. American Volume, 86(12), 26002606.
Mercadante, S. (1999). Opioid rotation for cancer pain. Cancer, 86(9), 18561866.
Mori, M., Elsayem, A., Reddy, S.K., et al. (2012). Unrelieved pain and suffering in patients with advanced cancer. American Journal of Hospice & Palliative Care, 29(3), 236240.
Portenoy, R.K. & Lesage, P. (1999). Management of cancer pain. Lancet, 353(9165), 16951700.
Portenoy, R.K., Thaler, H.T., Kornblith, A.B., et al. (1994). Symptom prevalence, characteristics and distress in a cancer population. Quality of Life Research, 3(3), 183189.
Prommer, E. (2012). Methylphenidate: Established and expanding roles in symptom management. American Journal of Hospice & Palliative Care, 29(6), 483490.
Reddy, A., Hui, D. & Bruera, E. (2012). A successful palliative care intervention for cancer pain refractory to intrathecal analgesia. Journal of Pain and Symptom Management, 44(1), 124130.
Richmond, C. (2005). Dame Cicely Saunders. BMJ, 331(7510), 238.
Ripamonti, C. & Bruera, E. (1997). CNS adverse effects of opioids in cancer patients: Guidelines for treatment. CNS Drugs, 8(3), 2137.
Stallmeyer, M., Zoarski, G.H. & Obuchowski, A.M. (2003). Optimizing patient selection in percutaneous vertebroplasty. Journal of Vascular and Interventional Radiology, 14(6), 683696.
Stone, C., Lawlor, P.G., Nolan, B., et al. (2011). A prospective study of the incidence of falls in patients with advanced cancer. Journal of Pain and Symptom Management, 42(4), 535540.
Yennurajalingam, S., Kwon, J.H., Urbauer, D.L., et al. (2013). Consistency of symptom clusters among advanced cancer patients seen at an outpatient supportive care clinic in a tertiary cancer center. Palliative & Supportive Care, 7, 18.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Palliative & Supportive Care
  • ISSN: 1478-9515
  • EISSN: 1478-9523
  • URL: /core/journals/palliative-and-supportive-care
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Keywords

Metrics

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed