FREE NEJM E-TOC    HOME   |   SUBSCRIBE   |   CURRENT ISSUE   |   PAST ISSUES   |   COLLECTIONS   |   Search Term  Advanced Search

Sign in | Get NEJM's E-Mail Table of Contents — Free | Subscribe

Previous Volume 335:1124-1132 October 10, 1996 Number 15 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

	Full Text PDF Purchase this article Letters Add to Personal Archive Add to Citation Manager Notify a Friend E-mail When Cited PubMed Citation

Pain from cancer is a major health care problem.^1,2,3 Thirty percent of patients with cancer have pain at the time of diagnosis, and 65 to 85 percent have pain when their disease is advanced.^2,4,5,6 The impact of cancer pain is magnified by the interaction of pain and its treatments with other common cancer symptoms: fatigue, weakness, dyspnea, nausea, constipation, and impaired cognition.^4,6 Cancer pain can be effectively treated in 85 to 95 percent of patients with an integrated program of systemic, pharmacologic, and anticancer therapy.^7,8 Many of the remaining patients can be helped by the appropriate use of invasive procedures.^9,10,11 . . . [Full Text of this Article]

Selection of the Appropriate Analgesic Therapy

Appropriate Analgesic Dosage

Route of Administration of Analgesic Drugs

Appropriate Intervals of Analgesic Dosing

Prevention of Persistent Pain and Relief of Breakthrough Pain

Titration of Analgesic-Drug Doses

Side Effects of Analgesic Drugs

Sequential Trials of Analgesic Drugs

Adjuvant Therapy

Conclusions

Source Information

From the Fox Chase Cancer Center, 7701 Burholme Ave., Philadelphia, PA 19111, where reprint requests should be addressed to Dr. Levy.

References

Related Letters:

Pharmacologic Treatment of Cancer Pain
Bruera E., Fainsinger R. L., Levy M. H.
Extract | Full Text  
N Engl J Med 1997; 336:962-963, Mar 27, 1997. Correspondence

This article has been cited by other articles:

• Bailey, F. A., Ferguson, L., Williams, B. R., Woodby, L. L., Redden, D. T., Durham, R. M., Goode, P. S., Burgio, K. L. (2008). Palliative Care Intervention for Choice and Use of Opioids in the Last Hours of Life. J. Gerontol. A Biol. Sci. Med. Sci. 63: 974-978 [Abstract] [Full Text]  
• (2008). Sensory neuron targeting by self-complementary AAV8 via lumbar puncture for chronic pain. Proc. Natl. Acad. Sci. USA 105: 1055-1060  
• Guilherme Soares, L., Chan, V. W. (2007). Review Article: The Rationale for a Multimodal Approach in the Management of Breakthrough Cancer Pain: A Review. AM J HOSP PALLIAT CARE 24: 430-439 [Abstract]  
• Pour, A. E., Parvizi, J., Sharkey, P. F., Hozack, W. J., Rothman, R. H. (2007). Minimally Invasive Hip Arthroplasty: What Role Does Patient Preconditioning Play?. JBJS 89: 1920-1927 [Abstract] [Full Text]  
• Hadi, I., Morley-Forster, P. K., Dain, S., Horrill, K., Moulin, D. E. (2006). Brief review: Perioperative management of the patient with chronic non-cancer pain: [Article de synthese court : Prise en charge perioperatoire des patients souffrant de douleur chronique non cancereuse]. Canadian J. Anesthesia 53: 1190-1199 [Abstract] [Full Text]  
• Ryan, M., Moynihan, T. J., Loprinzi, C. L. (2005). As-Needed Morphine: Yes, but at What Dose and at What Interval?. JCO 23: 3849-3852 [Full Text]  
• Soares, L. G. L. (2005). Methadone for cancer pain: What have we learned from clinical studies?. AM J HOSP PALLIAT CARE 22: 223-227 [Abstract]  
• Rudy, A. C., Coda, B. A., Archer, S. M., Wermeling, D. P. (2004). A Multiple-Dose Phase I Study of Intranasal Hydromorphone Hydrochloride in Healthy Volunteers. Anesth. Analg. 99: 1379-1386 [Abstract] [Full Text]  
• Anderson, S. L, Shreve, S. T (2004). Continuous Subcutaneous Infusion of Opiates at End-of-Life. The Annals of Pharmacotherapy 38: 1015-1023 [Abstract] [Full Text]  
• Yabroff, K R., Mandelblatt, J. S, Ingham, J. (2004). The quality of medical care at the end-of-life in the USA: existing barriers and examples of process and outcome measures. Palliat Med 18: 202-216 [Abstract]  
• Wong, G. Y., Schroeder, D. R., Carns, P. E., Wilson, J. L., Martin, D. P., Kinney, M. O., Mantilla, C. B., Warner, D. O. (2004). Effect of Neurolytic Celiac Plexus Block on Pain Relief, Quality of Life, and Survival in Patients With Unresectable Pancreatic Cancer: A Randomized Controlled Trial. JAMA 291: 1092-1099 [Abstract] [Full Text]  
• Flores, C. (2004). Management of Cancer Pain. JAMA 291: 1068-1068 [Full Text]  
• Bates, J. J., Foss, J. F., Murphy, D. B. (2004). Are Peripheral Opioid Antagonists the Solution to Opioid Side Effects?. Anesth. Analg. 98: 116-122 [Abstract] [Full Text]  
• Smith, H. S., Baird, W. (2003). Meloxicam and selective COX-2 inhibitors in the management of pain in the palliative care population. AM J HOSP PALLIAT CARE 20: 297-306 [Abstract]  
• Howard, F. M. (2003). Chronic Pelvic Pain. Obstet Gynecol 101: 594-611 [Abstract] [Full Text]  
• Bercovitch, M., Waller, A., Adunsky, A. (2002). Multidimensional continuous pain assessment chart (MCPAC) for terminal cancer patients: A preliminary report. AM J HOSP PALLIAT CARE 19: 419-425 [Abstract]  
• Ripamonti, C., Sweeney, C., Bruera, E. (2002). Use of Trade Names of Drugs and the Scientific Content of Medical Congresses. JCO 20: 1707-1708 [Full Text]  
• Landi, F., Onder, G., Cesari, M., Gambassi, G., Steel, K., Russo, A., Lattanzio, F., Bernabei, R., for the SILVERNET-HC Study Group, (2001). Pain Management in Frail, Community-Living Elderly Patients. Arch Intern Med 161: 2721-2724 [Abstract] [Full Text]  
• Akechi, T., Nakano, T., Okamura, H., Ueda, S., Akizuki, N., Nakanishi, T., Yoshikawa, E., Matsuki, H., Hirabayashi, E., Uchitomi, Y. (2001). Psychiatric Disorders in Cancer Patients: Descriptive Analysis of 1721 Psychiatric Referrals at Two Japanese Cancer Center Hospitals. Jpn J Clin Oncol 31: 188-194 [Abstract] [Full Text]  
• Rhodes, D. J., Koshy, R. C., Waterfield, W. C., Wu, A. W., Grossman, S. A. (2001). Feasibility of Quantitative Pain Assessment in Outpatient Oncology Practice. JCO 19: 501-508 [Abstract] [Full Text]  
• Robards, M. (2001). Transdermal fentanyl in the hospice: A survey of rescue dosing and pain control. AM J HOSP PALLIAT CARE 18: 47-50 [Abstract]  
• Yuan, C.-S., Foss, J. F. (2000). Oral Methylnaltrexone for Opioid-Induced Constipation. JAMA 284: 1383-1384 [Full Text]  
• Anderson, R., Saiers, J. H., Schlicht, C., Abram, S. (2000). Continuous infusion sufentanil for malignant pain: A case report. AM J HOSP PALLIAT CARE 17: 265-268  
• Coluzzi, P. H., Fairbairn, B. S. (1999). The management of pain in terminally ill cancer patients with difficulty swallowing. AM J HOSP PALLIAT CARE 16: 731-737  
• Mercadante, S., Casuccio, A., Calderone, L. (1999). Rapid Switching From Morphine to Methadone in Cancer Patients With Poor Response to Morphine. JCO 17: 3307-3312 [Abstract] [Full Text]  
• Abrahm, J. L., for the ACP-ASIM End-of-Life Care Consensus Panel, (1999). Management of Pain and Spinal Cord Compression in Patients with Advanced Cancer. ANN INTERN MED 131: 37-46 [Abstract] [Full Text]  
• Foley, K. (1999). A 44-Year-Old Woman With Severe Pain at the End of Life. JAMA 281: 1937-1945 [Full Text]  
• Lo, B., Quill, T., Tulsky, J., for the ACP-ASIM End-of-Life Care Consensus Panel, (1999). Discussing Palliative Care with Patients. ANN INTERN MED 130: 744-749 [Abstract] [Full Text]  
• Morize, V., Nguyen, D. T., Lorente, C., Desfosses, G. (1999). Descriptive epidemiological survey on a given day in all palliative care patients hospitalized in a French university hospital. Palliat Med 13: 105-117 [Abstract]  
• Du Pen, S. L., Du Pen, A. R., Polissar, N., Hansberry, J., Kraybill, B. M., Stillman, M., Panke, J., Everly, R., Syrjala, K. (1999). Implementing Guidelines for Cancer Pain Management: Results of a Randomized Controlled Clinical Trial. JCO 17: 361-361 [Abstract] [Full Text]  
• Hofmann, M. T., Farnon, C. U., Javed, A., Posner, J. D. (1998). Pain in the elderly hospice patient. AM J HOSP PALLIAT CARE 15: 259-265  
• Bernabei, R., Gambassi, G., Lapane, K., Landi, F., Gatsonis, C., Dunlop, R., Lipsitz, L., Steel, K., Mor, V., for the SAGE Study Group, (1998). Management of Pain in Elderly Patients With Cancer. JAMA 279: 1877-1882 [Abstract] [Full Text]  
• White, S., Wong, S. H. Y. (1998). Standards of laboratory practice: analgesic drug monitoring. Clin. Chem. 44: 1110-1123 [Abstract] [Full Text]  
• Bruera, E., Fainsinger, R. L., Levy, M. H. (1997). Pharmacologic Treatment of Cancer Pain. NEJM 336: 962-963 [Full Text]