Cancer Pain

1. Front Matter

   Pages i-xvii

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2. Cancer Pain Mechanisms and Etiology

   • Richard Payne

   Pages 1-10

3. Oral and Parenteral Drug Therapy for Cancer Pain

   • Richard Payne

   Pages 11-32

4. Psychological Aspects of Pain Due to Cancer

   • Charles S. Cleeland

   Pages 33-48

5. Radiotherapy, Chemotherapy and Hormonal Therapy in the Management of Cancer Pain: Putting Patient, Prognosis, and Oncologic Options in Perspective

   • Ross A. Abrams, Richard M. Hansen

   Pages 49-66

6. The Role of Nonneurolytic Nerve Blocks in the Management of Cancer Pain

   • Stephen E. Abram

   Pages 67-75

7. Intraspinal Narcotics for Intractable Cancer Pain

   • Dennis W. M. Coombs

   Pages 77-96

8. Application of Electrical Current to the Central Nervous System for Relief of Pain

   • Sanford J. Larson

   Pages 97-110

9. Neurolytic Blocks for Cancer Pain

   • Theresa Ferrer-Brechner

   Pages 111-124

10. Ablative Neurosurgical Procedures in Pain Related to Malignancy

    • Patrick R. Walsh

    Pages 125-135

11. Medicolegal Hazards of Destructive Nerve Blocks

    • Charles W. Quimby Jr.

    Pages 137-151

12. Hospice Care of the Cancer Pain Patient

    • Sheldon L. Burchman

    Pages 153-169

13. Back Matter

    Pages 171-173

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The diagnosis of cancer inspires fear, in part because of the high mortality rate associated with most malignancies, and in part because of the perception that cancer is a painful disease. Recently compiled statistics tend to support patients' fears. Pain is a major symptom in 70% of patients with advanced cancer [1]. Half of all patients undergoing anticancer therapy experience pain [2]. It has been estimated by members of the World Health Organization that 3. 5 million people worldwide suffer from cancer pain. One study of the severity of cancer pain estimates that pain is moderate to severe in 50% of cancer pain patients, very severe or excruciating in 30% [3]. An analysis of several reports of patients in developed countries estimates that 50-80% of patients had inadequate relief [2]. In underdeveloped countries, adequacy of treatment may be far lower because of lack of availability of medical facilities and legal constraints on the use of potent narcotics. The picture need not be this bleak. The reality is that, for most patients, cancer pain is relatively easy to control with simple, inexpensive measures. Several studies have indicated that cancer pain can be well controlled with oral morphine in over 90% of patients [4,5]. Long-acting orally effective opiate preparations such as time­ release morphine, methadone, and levorphanol allow patients to sleep comfortably through the night. When the oral route is impossible, narcotics can be administered rectally or by intravenous or subcutaneous infusion.

• Infusion
• Opiate
• cancer
• cancer therapy
• mortality
• pain

`This is an outstanding book ..., a valuable resource for health care professionals in clinical settings composed partially or totally of cancer patients. It proves indepth, clinically useful information about cancer pain treatment.'
Vivian R. Sheidler, Journal of the National Cancer Institute, Vol. 82, No. 1, January 3, 1990.

• Department of Anesthesiology, Medical College of Wisconsin, Milwaukee, USA

  Stephen E. Abram

• Pain Clinic, Milwaukee County Medical Complex, Milwaukee, USA

  Stephen E. Abram

Policies and ethics