Pain Management in Patients with Head and Neck Carcinoma

Abstract

Pain is one of the feared effects of advancing cancer and can affect a vast majority of head and neck cancer (HNC) patients. HNC's have a devastating impact on patient's lives as both disease and treatment can affect the ability to speak, swallow and breathe due to involvement of the aerodigestive tract. The etiology of pain in this subgroup of patients could be as a result of direct tumor progression, nerve root compression or as a result of the treatment modalities including surgery radiotherapy and chemotherapy. Pain experienced could be nociceptive or neuropathic. A thorough initial and ongoing assessment of the patient is essential for diagnosis and planning the treatment bearing in mind its modification during treatment. Treatment involves a comprehensive approach which is centred around systematic pharmacotherapy, and supplemented by a range of therapeutic interventions and physical and behavioral approaches. In this article we discuss the incidence, etiology, assessment and treatment of this challenging problem using current modalities.