title: The need for a multidisciplinary approach to pain management in advanced cancer: A clinical case.
abstract: Advanced cancer patients are often affected by multiple complex symptoms brought about by persistent nociceptive stimuli and intense psychosocial distress. One such complex symptom, cancer pain, has continued to pose a challenge in medical management even though the concept of total pain was described several years ago by Cicely Saunders. Oftentimes, the application of a multidisciplinary approach is delayed after numerous opioid dose escalations and invasive procedures have been performed. The case presented here highlights the importance of timely multidisciplinary intervention and the use of an acute palliative care unit, which resulted in adequate pain control after multiple medical and invasive procedures that caused toxicities.
authors.affiliation: Department of Internal Medicine,North Bend Medical Center,Coos Bay, Oregon.
authors.forename: Neha
authors.initials: N
authors.lastname: Didwaniya
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,University of Texas M D Anderson Cancer Center,Houston, Texas.
authors.forename: Kimberson
authors.initials: K
authors.lastname: Tanco
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,University of Texas M D Anderson Cancer Center,Houston, Texas.
authors.forename: Maxine
authors.initials: M
authors.lastname: de la Cruz
authors.affiliation: Department of Palliative Care and Rehabilitation Medicine,University of Texas M D Anderson Cancer Center,Houston, Texas.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Bruera
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000150:complications*; D059408:Pain Management / Q000379:methods*; D010148:Intractable Pain / Q000209:etiology* / Q000628:therapy*; D010166:Palliative Care / Q000379:methods*
chemical_list: D000701:Analgesics, Opioid
keywords: Total pain