Approximately four million people in the world die each year from cancer, which accounts for 10% to 20% of deaths from all causes.1 It is estimated that 50% to 60% of all patients with a terminal illness will have significant pain.2–4 Of these patients with pain, as many as 10% will have cancer pain that is considered intractable or refractory to medical management because of intolerable side effects with systemic medications and/or sedation causing significantly lowered mental status.5 The pain in these terminally ill patients is a direct result of the tumor in 65% to 75%, associated with or a result of the cancer therapy in 20% to 30% and unrelated to either in 5% to 10%.6,7 The etiology (ie, tumor, cancer therapy, or unrelated to either of these two causes) of the pain will greatly influence the choice and the efficacy of pain treatment options.
KeywordsSevere Pain Cancer Pain Transcutaneous Electrical Nerve Stimulation Algorithm Sequence Poor Prognosis Patient
Unable to display preview. Download preview PDF.
- 1.World Health Organization. Cancer as a global problem. Weekly Epidemiol Records. 1984;59: 125–126.Google Scholar
- 2.Bonica JJ. Importance of the problem. In: Bonica JJ, Ventafridda V, eds. Advances in Pain Research and Therapy. New York: Raven Press; 1979;2.Google Scholar
- 3.Bonica JJ. Treatment of cancer pain: current status and future needs. In: Fields HL, ed. Advances in Pain Research and Therapy. New York: Raven Press, 1985;9:589–616.Google Scholar
- 4.Bonica JJ, Ventafridda V, Twycross RG. Cancer pain. In: Bonica JJ, ed. The Management of Pain. Philadelphia, Pa: Lea & Febiger; 1990;400–460.Google Scholar
- 5.Baines M, Kirkham SR. Cancer pain. In: Wall PD, Melzack R, eds. Textbook of Pain. New York: Churchill Livingstone; 1989;590–597.Google Scholar
- 6.Foley KM. Control of pain in cancer. In: Calabrisi P, Schein P, Rosenberg SA, eds. Medical Oncology: Basic Principles and Clinical Management of Cancer. New York: Macmillan; 1985;1385–1405.Google Scholar
- 10.Bonica JJ, ed. Clinical Applications of Diagnostic and Therapeutic Nerve Blocks. Springfield, Ill: Charles C. Thomas; 1959.Google Scholar
- 16.Tasker RR. Percutaneous cordotomy: the lateral high cervical technique. In: Schmidek HH, Sweet WH, eds. Operative Neurosurgical Techniques. Indications, Methods, and Results. New York: Grune & Stratton; 1988;1191–1205.Google Scholar
- 17.Papo I. Spinal posterior rhizotomy and commissural myelotomy in the treatment of pain. In: Bonica JJ, Ventrafridda V, eds. Advances in Pain Research and Therapy. New York: Raven Press; 1979;2:439.Google Scholar
- 21.Laitinen LV. CT-guided ablative stereotaxis without ventriculography. Appl Neurophysiol. 1985;48:1821.Google Scholar
- 24.Tasker RR. Pain due to central nervous system pathology. In: Bonica JJ, ed. The Management of Pain. Philadelphia, Pa: Lea & Febiger; 1990:264–283.Google Scholar