“A bad death is a medical emergency,” said Robert A. Swarm, MD, during a presentation at the recent NCCN 18th Annual Conference, quoting Dame Cicely Saunders, the mother of the hospice movement. Dr. Swarm is Professor of Anesthesiology and Chief of Pain Management at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine and Chair of the NCCN Panel on Adult Cancer Pain.
The key current goals for controlling cancer pain are to 1) fully integrate symptom control into comprehensive cancer care, which includes prevention, detection, and treatment; 2) develop and implement disease- and site-specific cancer pain management protocols; and 3) provide pain management care paths for cancer survivors, 30% to 40% of whom are left with chronic cancer-related pain.
Too often, Dr. Swarm said, “We wait for patients to present with pain at a magnitude of 8 or 9 on a 10-point scale. We don’t have care paths in place to help us identify patients at risk for that severe pain and to implement therapies in a prospective way. We need to respond to poor symptom control with urgency, but the goal is to avoid the emergency and treat according to a consistent care path.” Pain management must be a priority, and this will require clearly defined medical leadership in this area, he added.
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