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Cancer pain control: an evidence-based approach
A selection of talks on Neuroscience
Roles of microglia in the healthy brain
- Dr. Marie-Ève Tremblay
- University of Victoria, Canada
Bioelectronic medicine: immunomodulation by vagus nerve stimulation
- Prof. Paul Peter Tak
- Amsterdam University Medical Centre, The Netherlands
Hello. My name is Dr. Daniel Carr. I'm very happy to be speaking with you today about the topic of cancer pain control. I'm going to take an evidence-based approach, the meaning of which I will explain during the lecture. I am the Saltonstall Professor of Pain Research, in the Department of Anesthesia at Tufts Medical Center in Boston, Massachusetts. I also serve as Chief Medical Officer of Javelin pharmaceuticals in Cambridge, Massachusetts.
I'd like to begin this talk by pointing out that the control of pain, or at least efforts to control pain, is becoming viewed increasingly as a fundamental human right. This process has been evident for about a generation, beginning in the 1970s, with several different origins of recognition that sub-optimal pain management could be improved. This recognition arose from the modern hospice movement, and was also manifest in organizations such as the International Association for the Study of Pain, which was founded in 1975. Cancer pain relief, in particular, was explicitly declared a priority of the World Health Organization in the early 1980s. This led to the publication of the WHO method for cancer pain relief, that I'll speak about later in this talk. In the United States, in the late 1980s, a government agency called the Agency for Healthcare Policy and Research began guidelines on high-impact conditions, and pain was among these. At the same time, these particular events took place against a backdrop of mega-trends. These mega-trends involved a shift of patient care, to be focused upon the patient rather than upon the care provider, in particular, the physician. There was also a growing focus on health-related quality of life, as exemplified in the outcomes movement. There was also legislative and judicial progress. Since that time in the 1990s, and now well along in the 2000s, there have been many professional, governmental, and non-governmental organizational efforts, devoted to the control of pain in general, and in particular to cancer pain control. The biology of pain has been better understood, so that pain, in particular chronic pain, is increasingly viewed as a disease per se, but I emphasize that the control of, or at least efforts to control, pain is increasingly viewed as a fundamental human right.