Up to 50% patients experienced varying degree of discomfort and pain in early stages of cancer. A significant proportion with advanced cancer have moderate to severe pain in multiple sites, with some progressing to intractable pain despite multi-modal analgesia and cancer therapy. Thus, the modified WHO analgesic ladder has incorporated pain procedures to fast track the management of severe refractory pain. However, pain intervention is not the magic bullet and does have its limitation and complications. Thus physician must assess the patient holistically and managed the family’s expectation in order to optimise the outcome. In this talk, we will explore the various regional anaesthetic block and ablative pain procedures (e.g. radiofrequency lesioning, cryotherapy, neurolysis, epidural and intrathecal therapy) that can be employed to maximize patient’s comfort.
