Page 18 - CPG - Clinical Practice Guidelines - Management of Cancer Pain
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Management of Cancer Pain (Second Edition)
ALGORITHM 3. MANAGEMENT OF CANCER PAIN IN CHILDREN
Cancer patient with pain
Assessment - History/Physical Examination/Investigation
Diagnosis
• Type - Nociceptive/Neuropathic/Mixed
• Source - Cancer-related/Non-cancer-related
• Severity - Pain Score
Pain Score
Mild Cancer Pain Moderate Cancer Pain Severe Cancer Pain
(Pain Score: 1 - 3) (Pain Score: 4 - 6) (Pain Score: 7 - 10)
WHO LADDER STEP llI
• Opioids
WHO LADDER STEP lI ± Non-opioid
• Opioids analgesics
WHO LADDER STEP I ± Non-opioid ± Adjuvants
• Non-opioid analgesics
analgesics ± Adjuvants
(paracetamol,
NSAIDs,
COX-2 inhibitors)
± Adjuvants No Refer to
Pain Palliative
Control Care Team/
No
Pain Pain
No Control Yes Specialist
Pain
Control
Yes
Yes
Reassessment
and Follow-up
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