title: Recent advances in cancer pain management.
abstract: Pain is the most feared symptom of cancer. New oncological cancer treatments are improving survival, but advanced cancer presents challenges that have not been seen before, often with pain that is very difficult to manage because of a recurrent tumour that is invading the central nervous system. In some of the older interventional techniques of destroying nerve pathways, expertise has diminished or has been deemed unnecessary with the development of specialist palliative care. Not all pain is managed adequately with the analgesic ladder. Knowledge of pain mechanisms, careful assessment and selection of the right technique at the right time will enhance cancer pain management. New techniques include intrathecal drug therapy, vertebroplasty, cordotomy, ultra-sound guided nerve blocks, neuromodulation and advances in drug therapies.
authors.affiliation: Department of Anaesthetics St George's Hospital, Blackshaw Road, Tooting, London SW17 0QT UK.
authors.forename: James
authors.initials: J
authors.lastname: Wilson
authors.affiliation: Department of Anaesthetics King's College Hospital, Denmark Hill, London SE5 9RS UK.
authors.forename: Catherine
authors.initials: C
authors.lastname: Stack
authors.affiliation: Department of Anaesthetics King's College Hospital, Denmark Hill, London SE5 9RS UK.
authors.forename: Joan
authors.initials: J
authors.lastname: Hester