Anesthesiology

Cancer Pain/Palliative Care Rotation

Goals:

To appreciate the differences in managing cancer pain and chronic non-malignant pain
To understand the multidisciplinary clinical approach and treatment strategies necessary for palliating patients at the end of life

Objectives:

To demonstrate knowledge of the epidemiology of pain in the cancer population (ex: peripheral neuropathy – chemo; mucositis – radiation therapy)
To recognize and initiate treatment for emergent causes of pain in the cancer population (ex: HA-brain met; back pain-cord compression)
To recognize treatable causes of pain in the cancer population (ex: bone met – radiation therapy)
To learn to titrate opioids (via all available routes of administration, including subcutaneous pumps), and to treat associated toxicities of opioids in the cancer pain population
To gain experience in pharmacologic management in pain in patients with end-stage organ disease which affects absorption, metabolism, excretion of medications; to effectively anticipate and/or treat adverse side effects of medications in this setting
To treat patients and families with respect and dignity
To empower patients to participate in medical decision-making at the end of life
To recognize psychological, social, spiritual, and economic issues which may affect patients and their families, and necessitate adjustment in management plan to accommodate these
To explore the multidisciplinary resources necessary in order to effectively treat terminal/cancer patients with pain, and to work well within the team providing them
To maintain continuity with inpatients with chronic cancer/terminal pain, and to adjust plans accordingly based on daily assessment