Tutorial 4: Cancer pain


FPM curriculum on cancer pain

3.6 Pain related to cancer Thirty per cent of patients with cancer will have pain at diagnosis. Seventy per cent will have pain by the time their disease is advanced. Yet the outcomes for management of cancer pain are often poor. Management of pain in the presence of a terminal illness is different from the management of acute or chronic pain, but uses techniques from both fields. This essential topic area also addresses chronic pain experienced by patients arising out of successful management of their cancer.


  1. Definition of cancer pain; types of cancer pain
  2. Principles of opioid rotation, toxicity of high dose opioids
  3. Role of WHO ladder
  4. Management of metastatic cancer spinal pain
  5. Management of pain CA pancreas-role of blocks
  6. Role of bisphosphonates, denosumab, calcitonin,  ketamine, steroids, radiotherapy
  7. Hypercalcaemia, nausea and vomiting, sedation
  8. Intrathecal and subcutaneous routes
  9. Pain specialist in palliative care

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