A perspective on a precision approach to pain in cancer; moving beyond opioid therapy

Abstract

Purpose

Cancer-related pain is primarily treated with opioids which while effective can add significant patient burden due to side effects, associated stigma, and timely access. The purpose of this perspective discussion is to argue for a precision approach to pain in cancer based on a biopsychosocial and spiritual model which we argue can offer a higher quality of life while limiting opioid use.

Conclusions

Pain in cancer represents a heterogenous process with multiple contributing and modulating factors. Specific characterization of pain as either nociceptive, neuropathic, nociplastic, or mixed can allow for targeted treatments. Additional assessment of biopsychosocial and spiritual issues can elucidate further points of targeted intervention which can lead to overall greater pain control.

IMPLICATIONS FOR REHABILITATION

• Precision Pain Management in Cancer

• Pain in cancer is complex and heterogeneous with multiple contributing etiologies.

• A comprehensive assessment addressing the biopsychosocial and spiritual aspects of pain may lead to better control.

• Utilizing multiple targeted treatment strategies may help to curb opioid use.

Keywords:

• Cancer pain
• cancer-related pain
• neoplasm-related pain
• biopsychosocial model
• precision medicine
• pain management

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

The author(s) reported there is no funding associated with the work featured in this article.