Pain management and side effect risks in palliative care for cancer patients: A review

Rusmini, Sri and Yunitasari, Esti and Nihayati, Hanik Endang (2025) Pain management and side effect risks in palliative care for cancer patients: A review. World Journal of Advanced Research and Reviews, 26 (2). pp. 4477-4482. ISSN 2581-9615

Cancer-related pain remains one of the most prevalent and distressing symptoms in palliative care, significantly diminishing the quality of life for patients. This review examines contemporary approaches to cancer pain management, evaluating both pharmacological and non-pharmacological interventions. A systematic literature review was conducted in accordance with PRISMA guidelines, searching databases including PubMed, ProQuest, ScienceDirect, Scopus, and EBSCOhost for studies published between 2018 and 2024. Studies were included if they addressed pain management within palliative care settings and were excluded if they lacked empirical data. Eight studies met the inclusion criteria and were analyzed using a standardized data extraction method. Findings highlight that opioid therapy, guided by the WHO’s analgesic ladder, remains the cornerstone of pain control. However, opioids carry risks such as respiratory depression, sedation, and gastrointestinal side effects, necessitating vigilant monitoring. Adjuvant analgesics, including corticosteroids, anticonvulsants, and antidepressants, offer complementary relief but can lead to adverse effects such as immunosuppression and cognitive dysfunction. Non-pharmacological interventions including acupuncture, physical therapy, music therapy, and psychosocial support demonstrated effectiveness in enhancing pain relief and emotional well-being. Despite advancements, significant disparities in access to effective pain management persist, especially in low- and middle-income countries. Barriers include limited healthcare infrastructure, insufficient provider training, cultural misconceptions, and restrictive regulations on opioid distribution. A multidisciplinary, patient-centered approach is essential to optimize pain control, integrating both medical and supportive therapies. Enhancing provider education, reforming policy, and addressing healthcare inequities are critical to improving outcomes and reducing the burden of cancer pain in palliative care globally.