Pain and Symptom Management in Palliative Care

BACKGROUND: Pain, dyspnea, and anorexia are common symptoms experienced by patients with cancer and often are poorly managed. METHODS: The incidence and causes of these symptoms are described, as well as factors that exacerbate or ameliorate their impact. RESULTS: Pharmacologic management of cancer pain is based on the use of a sequential "ladder" that incorporates nonopioid, opioid, and adjuvant drugs, depending on the severity of the pain. This approach usually is effective. Other symptoms of advanced disease may be more difficult to control. CONCLUSIONS: Adherence to an adequate pain-control strategy will significantly enhance palliation of pain in patients with cancer.