Great strides have been made in the last 10 years, both in acknowledging the need to aggressively treat cancer pain to improve quality of life, as well as having the medical infrastructure in place to appropriately assess patients and provide them access to the various therapies for cancer pain management. Oncologists’ awareness and access to both palliative care physicians and specialist pain medicine physicians have improved significantly in recent years. Certainly, in most Australian capital cities and large regional areas, there is access to appropriate medications, psychological support, and interventional pain management techniques to manage both simple and complex cancer pain.
Whilst opioids are appropriately one of the mainstays of managing cancer pain, there has been an improvement in understanding that some of the more modern and newer opioids, such as the atypical opioids, may have a significantly improved place in managing cancer pain in terms of reducing the side effects and slowing the development of tolerance to the opioid over time. It is important that, in the mindset of general practitioners, there is a clear understanding that whilst there is little role for long-term conventional opioids in chronic non-cancer pain, the situation has not changed for both acute pain management and cancer pain management.
Perhaps one of the issues we are currently seeing is the progressive budgetary restrictions in public hospital pain clinics that have, at least anecdotally, made it more difficult for them to fully service the cancer patients’ needs. There is a concern amongst clinicians that further budgetary restrictions may impact this further.
Whilst there is certainly an avalanche of research and development being conducted around the world, especially in the United States, on novel pharmacological ways to improve cancer pain management, the fact remains that comprehensively following patients up and ensuring that their care is optimised is the simplest way of improving outcomes in the here and now and this requires no specific further research and development breakthroughs. In talking to patients and especially the home caregivers of patients, one can see that there are still gaps in the system that can be improved.
At Hunter Pain Specialists, we encourage patients to speak openly to their general practitioner and specialists to ensure that their voices are being heard and their pain needs are being met.