A Physician's Guide to Pain and Symptom Management in Cancer Patients

Janet L. Abrahm, M.D

Course Outline

Janet L. Abrahm argues that all causes of suffering experienced by people with cancer? be they physical, psychological, social or spiritual? should be treated at all stages: at diagnosis, during curative therapy, in the event that cancer recurs, and during the final months. In this symptom-oriented guide, she provides family physicians, internists, oncologists, and nurses with detailed information and advice for alleviating the stress and pain of patients and family members.

Guide to Pain and Symptom Management In Cancer Patients includes the latest information on patient and family communication and counseling; on medical, surgical, complementary, and alternative treatments for symptoms caused by cancer and cancer treatments; and on caring for patients in their last days. Case histories, current medication tables, practice points, and bibliographies provide clinicians with the information they need to treat their cancer patients effectively and compassionately.

About the Authors

Janet L. Abrahm, M.D., is an associate professor of medicine at Harvard Medical School and director of the Pain and Palliative Care Programs at the Dana-Farber Cancer Institute.

Learning Objectives

After completing this course you’ll be able to:

1. Explain at least 7 major points to consider when breaking bad news to patients.
2. Identify actions to take after breaking bad news to patients.
3. Discuss psychological problems faced by patients newly diagnosed with cancer.
4. Explain how to discuss advanced directive planning with patients and families.
5. Explain the difference between addiction and physical dependence.
6. Identify ways that cancer patients can overcome their fear of becoming addicted to prescribed pain medications.
7. Identify common side effects of opioid medications.
8. Discuss religious beliefs that may affect patients’ and families’ attitudes about use of pain medications.
9. Identify strategies to increase compliance with medication orders.
10. Describe the impact health-care professionals can have on a pain management plan.
11. Identify the components of a good death.
12. Explain the effects of conflicting views of patients, families, and caregivers.
13. Discuss ways to identify and reconcile priorities of patients, families, and caregivers.
14. Identify ways to help patients and families transition from active treatment to comfort care.
15. Describe benefits of hospice care.
16. Explain how to deal with requests for patient-assisted suicide.
17. Identify techniques for caring for self when caring for cancer patients.
18. Explain the ACHPR guidelines to assess pain in cancer patients.
19. Describe the use of pain intensity scales.
20. Compare somatic, visceral, and neuropathic pain.
21. Discuss the affective and cognitive dimensions of cancer pain.
22. Identify symptoms of delirium that may be exhibited by cancer patients.
23. Identify social, cultural, and familial attitudes that can affect assessment and treatment of cancer pain.
24. Explain the use of nonsteroidal anti-inflammatory drugs in the treatment of cancer pain.
25. Identify ways to prevent NSAID toxicity.
26. Discuss guidelines for use of opioid medications in treating cancer pain.
27. Explain the use of the analgesic ladder in treating cancer pain.
28. Explain why meripidine should not be used for chronic cancer pain.
29. Compare and contrast various methods of administering opioid medications.
30. Describe ways to manage common side effects caused by opioid medications.
31. Discuss the occurrence and management of respiratory depression.
32. Discuss three categories of medications used as adjuvant analgesia.
33. Explain the use of anesthetic agents in treating cancer pain.
34. Explain how to implement a pain management plan.
35. Discuss the use of body-based methods of treating cancer pain.
36. Explain common mind-body interventions used for pain management.
37. Explain ways to manage anxiety and depression experienced by cancer patients.
38. Identify effective ways to manage common oral complications experienced by cancer patients.
39. Discuss the treatment of chemotherapy-induced nausea and vomiting.
40. Discuss treatment of common respiratory problems cancer patients may have.
41. Describe recognition and treatment of skin problems that may be associated with various forms of cancer and cancer treatment.
42. Discuss pharmacologic and nonpharmacologic treatment of insomnia.
43. Describe strategies for dealing with symptoms such as fatigue, weakness, and anorexia.
44. Discuss the role of a palliative care team.
45. Identify qualities care givers must have when caring for dying patients.
46. Describe signs that indicate that a transition to the last days of life is occurring.
47. Explain how to provide support for families of dying patients.
48. Discuss problems and needs of inpatient staff caring for dying patients.
49. Identify manifestations of death that occur in the last 1-2 weeks before death.
50. Describe strategies used to manage the symptoms occurring during the last days of life.
51. Explain how to manage agitation in the last days.
52. Discuss the steps of the mourning process experienced by the bereaved family.
53. Describe techniques that can be implemented in an effective bereavement program.

Course Contents

Part I. Hidden Concerns, Unasked Questions
1. Early Days
2. Helping Patients Accept Opioid Pain Medication
3. Approaching the End
Part II. Pain Control and Symptom Management
4. Assessing the Patient in Pain
5. Pharmacologic Management of Cancer Pain
6. Nonpharmacologic Strategies for Pain and Symptom Management
7. Managing Other Distressing Problems
8. The Last Days….and the Bereaved


“Important for all dimensions of patient care? not just cancer. Every doctor in clinical practice needs this book. Every patient will benefit from it.” - Christine K. Cassel, M.D., Mount Sinai School of Medicine

“Every health-care professional needs this book. A practical and concise guide, it is an excellent resource that should be used to prevent and treat suffering as health-care professionals accompany the patient and family through the experience of living with cancer.” - Oncology Nursing Forum

“For clinical sophistication, insight into the complexities of doctor-patient communication, and detailed guidance on the treatment of a wide range of distressing symptoms, clinicians will turn again and again to this practical and concise guide as they accompany patient and family through the late stages of illness.” - Diane Meier, M.D., Mount Sinai School of Medicine

Go Back

© 2007 - 2009 Homestead Schools, Inc.  -  Webmaster: ITSYS Solutions