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- Scope of the Problem
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1. Cancer pain
- Prof. Judith Paice
- Current Therapies
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3. Spinal analgesia for cancer pain
- Prof. Jon Raphael
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4. Celiac plexus block
- Prof. David Brown
- Future Directions
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6. Symptom control: using technology pragmatically
- Dr. Steven Richeimer
- From Palliative Care to Chronic Pain
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7. Insight and responsibility: ethics in pain medicine and palliative care
- Prof. Rollin Gallagher
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8. The patient with pain: a palliative care approach
- Dr. Janet Abrahm
- Archived Lectures *These may not cover the latest advances in the field
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9. Cancer pain and related symptoms: an overview
- Prof. Judith Paice
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10. Cancer pain control: an evidence-based approach
- Prof. Daniel Carr
- Dr. Baraa Tayeb
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11. Optimal treatment of chronic pain
- Prof. Gordon Irving
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12. Chronic cancer pain: the price of success?
- Prof. Allen Burton
Printable Handouts
Navigable Slide Index
- Introduction
- Pain control: A human right?
- Traditional view of cancer pain control
- The importance of cancer pain control
- Clinical practice guideline: Cancer pain
- Cancer pain control - ABCDE
- Assessing cancer pain
- Sources of cancer pain
- Matching pain mechanism to Rx
- WHO ladder: Severity-based Rx
- AHCPR pyramid + ribbon
- Nonopioid analgesics (1)
- Nonopioid analgesics (2)
- Nonopioid analgesics (3)
- Nonopioid analgesics (4)
- Nonopioid analgesics (5)
- Opioids
- Opioids: Morphine dosing (1)
- Opioids: Morphine dosing (2)
- Opioids: Morphine
- Opioids: Switching from morphine
- Opioids: Opioid side effects
- Opioids: Neuraxial route
- Adjuvant analgesics: Introduction
- Adjuvant analgesics: Anticonvulsants
- Adjuvant analgesics: Antidepressants
- Adjuvant analgesics: Miscellaneous
- Other analgesic modalities
- Barriers to cancer pain assessment, treatment
- EBP - Evidence based practice
- Maimonides on bias
- Types of evidence
- Evidence: Strength, consistency
- Systematic reviews vs. narrative reviews
- Agency for health care research and quality
- AHRQ publications free for download
- Background: EPC reviews
- Marcus Aurelius on symptom clusters
- Prevalence: Pain
- Assessment: Pain
- "Pain evidence": Problems
- Treatment: Pain (1)
- Treatment: Pain (2)
- Treatment: Pain (3)
- In an ideal world...
- Cancer pain: Future research
- Acknowledgments
Topics Covered
- Importance of cancer pain control
- Assessment and sources of cancer pain
- Selecting agents according to pain mechanism
- The WHO ladder
- Nonopioids and adjuvants
- Opioids
- Side effects
- Neuraxial drug delivery
- Nondrug modalities
- What does the published evidence show?
- Update talk: Changes in cancer pain control since 2009
Links
Series:
Categories:
Therapeutic Areas:
Talk Citation
Carr, D. and Tayeb, B. (2021, November 30). Cancer pain control: an evidence-based approach [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved September 1, 2024, from https://doi.org/10.69645/JSTD8926.Export Citation (RIS)
Publication History
Financial Disclosures
- Prof. Daniel Carr has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
- Dr. Baraa Tayeb has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.
Update Available
The speaker addresses developments since the publication of the original talk. We recommend listening to the associated update as well as the lecture.
- Full lecture Duration: 74:02 min
- Update Duration: 14:06 min
A selection of talks on Oncology
Transcript
Please wait while the transcript is being prepared...
0:00
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.
0:34
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.