Unrelieved Pain and Suffering in Patients With Advanced Cancer

Masanori Mori, Ahmed Elsayem, Suresh K. Reddy, Eduardo Bruera, Nada A. Fadul

Research output: Contribution to journalReview articlepeer-review

18 Scopus citations


Even with specialist-level palliative care, cancer pain can be difficult to treat especially when the pain is complicated by profound suffering. It is paramount to consider not only the patients' biochemical factors but also their psychosocial and spiritual/existential influences. A multidimensional approach with knowledge of the risk factors for poor pain control is important to prevent, detect, and manage risk factors for intractable pain, including psychosocial distress, addictive behavior, and delirium in patients with terminal cancer. We present 3 cases of patients with advanced cancer with intractable bone pain whose hospital courses were complicated by severe psychosocial distress and delirium. We also propose an algorithm of multidimensional approach to unrelieved pain and suffering in patients with advanced cancer.

Original languageEnglish (US)
Pages (from-to)236-240
Number of pages5
JournalAmerican Journal of Hospice and Palliative Medicine
Issue number3
StatePublished - May 2012
Externally publishedYes


  • advanced cancer
  • cancer pain
  • chemical coping
  • delirium
  • multidimensional approach
  • psychosocial distress

ASJC Scopus subject areas

  • Medicine(all)


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