Review Article

Pain Prevention Using Head and Neck Cancer as a Model

Erin M. McMenamin, MSN, CRNP, AOCN®, ACHPN, and Marcia Grant, RN, PhD, FAAN

Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, and City of Hope National Medical Center, Duarte, California

Authors' disclosures of potential conflicts of interest are found at the end of this article.

Erin McMenamin, MSN, CRNP, AOCN®, ACHPN, Hospital of the University of Pennsylvania, Radiation Oncology, 3400 Civic Center Boulevard, 2 TRC, Philadelphia, PA 19104. E-mail: erin.mcmenamin@uphs.upenn.edu

ABSTRACT

Pain is a common and often debilitating consequence of cancer and its treatment. Efforts to improve pain management for patients diagnosed with cancer have not resulted in widespread patient reports of acceptable management of pain. Patients and providers alike remain opiophobic due to a number of issues, resulting in suboptimal management of pain. Recent literature has revealed that it may be possible to prevent pain related to cancer and its treatment and therefore avoid or decrease the amount of opioids used to treat pain. This may result in better quality of life for patients. Several newer antiepileptic drugs (AEDs) have been found to decrease the perception of pain in a number of patient populations, including those with head and neck cancer. The side-effect profile for the newer AEDs is mild and well tolerated. Future efforts should focus on the use of newer AEDs to prevent pain in other cancer populations, with a focus on ideal dose and scheduling. Once established, recommendations regarding the prevention of pain in patients with cancer can be incorporated into national guidelines.

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