Pain relief in metastatic cancer

The competent management of pain in patients with advanced cancer draws upon in-depth knowledge of cancer and its complications, diagnostic acumen, expertise in the administration of analgesics, and an understanding of a patient in their entirety. Patients with advanced prostate cancer are now living longer with multiple chronic symptoms pain, which can be the cause of much distress for both patients and their families. Bone is a predominant site of metastases in prostate cancer and as such is a common site of pain. Newly developed models of bone pain are leading to promising novel therapeutic options that possess both tumor-specific and analgesic properties. Clinicians managing pain in the patient with advanced cancer need to remain open and available to their patients as they approach their death. Integrating skills in pain management with skills in caring for the dying patient speaks to the heart of medical practice which is the relief of suffering.