title: The impact of a comprehensive evaluation in the management of cancer pain.
abstract: To evaluate the importance of a comprehensive evaluation in the management of patients with cancer pain, we surveyed 276 consecutive consultations (226 retrospectively and 50 prospectively) performed by the pain consultant at Memorial Sloan-Kettering Cancer Center. For all consultations, the pain diagnosis, other medical and neurologic diagnoses, investigations and suggested therapeutic interventions were recorded. The pain consultation identified a previously undiagnosed etiology for the pain in 64% of patients in both surveys. Metastatic neoplasm was the most common lesion discovered. In addition, the prospective survey yielded new neurologic diagnoses in 36% of patients and an unsuspected infection in 4%. Eighteen percent of prospectively surveyed patients received radiotherapy, surgery or chemotherapy based on the findings of the pain consultant. These data confirm the importance of a comprehensive neuro-oncologic evaluation in the management of cancer pain. An understanding of oncology, neurology and medicine is critical to assess and treat these patients.
authors.affiliation: Pain Service, Department of Neurology, Memorial Sloan-Kettering Cancer Center, New York, NY 10021 U.S.A.
authors.forename: Gilbert R
authors.initials: GR
authors.lastname: Gonzales
authors.forename: Kathryn J
authors.initials: KJ
authors.lastname: Elliott
authors.forename: Russell K
authors.initials: RK
authors.lastname: Portenoy
authors.forename: Kathleen M
authors.initials: KM
authors.lastname: Foley
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000209:etiology; D059408:Pain Management; D011446:Prospective Studies; D012189:Retrospective Studies