Pain management in the older cancer patient

Although surveys suggest that the prevalence of pain may be less among older cancer patients than their younger counterparts, chronic pain in an elderly patient is a common problem in clinical practice. The adverse consequences of pain may be magnified in this population due to the concurrence of other age-related medical and psychosocial problems, and treatment may be complicated by assessment difficulties and physiological changes that increase the risks of therapy. The management of cancer pain in the older patient requires ongoing assessment and a multimodal treatment approach that recognizes and accommodates these age-related processes. When prescribing analgesics for elderly patients, it is best to (1) use drugs that have a short half-life, if available, (2) prescribe one drug at a time, (3) begin with low doses, (4) be aware of additive effects, and (5) continue drug trials for an adequate duration.