Managing pain from advanced cancer in the palliative care setting.
Managing complex pain at the end of life is an essential aspect of palliative care. Such care is best guided by a comprehensive evaluation of the physiologic sources of pain to determine appropriate analgesia. Using the case of Mrs. J, a woman with advanced ovarian cancer, key principles of complex pain management at the end of life are reviewed, including optimum use of opioids and co-analgesics. In addition to physical assessment, total care of the patient and family facing imminent death should be based on an assessment of psychological, social, and spiritual factors. The assessment and management of pain and suffering are guided by an interdisciplinary team focused on goals of comfort and facilitating a death that respects the life of the patient who is dying.
Ferrell
Betty
B
City of Hope National Medical Center, Duarte, CA, USA. bferrell@coh.org
Levy
Michael H
MH
Paice
Judith
J
D000698:Analgesia / Q000379:methods* / Q000451:nursing; D000701:Analgesics, Opioid / Q000627:therapeutic use; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D005260:Female; D006694:Holistic Health; D006801:Humans; D020407:Internet; D008875:Middle Aged; D009730:Nursing Assessment; D009859:Oncology Nursing / Q000379:methods*; D010051:Ovarian Neoplasms / Q000150:complications*; D010146:Pain / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement / Q000379:methods / Q000451:nursing; D010166:Palliative Care / Q000379:methods*; D010347:Patient Care Planning; D010348:Patient Care Team / Q000458:organization & administration; D018579:Patient Selection; D017410:Practice Guidelines as Topic; D012720:Severity of Illness Index; D029181:Spirituality; D013810:Therapeutic Equivalency
D000701:Analgesics, Opioid; D000893:Anti-Inflammatory Agents; D000929:Antidepressive Agents, Tricyclic