CACA guidelines for the management of adult cancer pain

Abstract

Cancer pain, one of the most prevalent and distressing symptoms in cancer patients, is closely associated with cancer diagnosis, therapeutic interventions, quality of life, and survival outcomes. Effective cancer pain management requires multidisciplinary collaborative and multimodal approaches throughout the disease trajectory. To address this imperative, the Cancer Pain Integration Therapy Professional Committee of the China Anti-Cancer Association (CACA) convened domestic experts in oncology pain management. From the perspective of holistic integrative medicine (HIM), this guideline was developed to standardize pain assessment and diagnostic protocols, pharmacotherapy, minimally invasive analgesic techniques, palliative antitumor therapies and other adjunctive analgesic modalities, as well as definitions of treatment-related pain syndromes, refractory cancer pain syndromes, etc. This guideline aims to enhance health care professionals’ overall competency in cancer pain diagnosis, treatment, and comprehensive management through evidence-based, patient-centered, and system-integrated strategies. 1. Multidisciplinary (MDT-to-HIM), individualized strategies are needed to target pain relief, comorbidities and tumor-directed therapy. 2. Accurate assessment and diagnosis are mandatory prerequisites for guideline-consistent analgesia. 3. Pharmacotherapy remains first-line: optimize opioid use, titrate doses, prevent/manage adverse effects. 4. Minimally invasive techniques (PCIA/PCSA, nerve block/lysis, intrathecal analgesia, vertebroplasty) enhance efficacy while sparing systemic opioids. 5. Special cancer pain phenotypes require tailored, protocol-integrated regimens plus continuous patient education. 6. Overcome barriers—outdated concepts, opioid access, nonstandard care, weak MDT-to-HIM—to extend both survival and QoL.