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General Discussions

Managing Chronic Pain in Adult Survivors

By Lisa Schulmeister, MN, RN, ACNS-BC, FAAN
On July 25, 2016, the American Society of Clinical Oncology (ASCO) released guidelines on pain management for adult cancer survivors. ASCO notes that there are over 14 million cancer survivors in the United States, and as many as 40% continue to experience persistent treatment-related pain.

Key guideline recommendations include screening for pain at every patient encounter; assessing for the risk of adverse effects of opioids to minimize abuse; and using nonpharmacologic interventions such as physical medicine and rehabilitation, integrative therapies (eg, acupuncture and massage), interventional therapies, and psychological approaches (eg, guided imagery, hypnosis, and meditation).

Also recommended is using systemic non-opioid analgesics (NSAIDS, acetaminophen) and adjuvant analgesics (selected antidepressants and anticonvulsants) to relieve chronic pain and/or improve physical function. The experts recommend following state regulations that allow access to medical cannabis or cannabinoids for patients with chronic pain after considering the potential benefits and risks of the available formulations.

These guidelines are the first of their kind to be specifically directed to cancer survivors; consequently, they have the potential to address the pain management needs of this population of patients.
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