Anticancer drugs for pain associated with cancer in palliative care

Anticancer drugs may reduce pain associated with many cancers (eg head and neck, pancreatic, breast, lung, prostate) by reducing the size of the tumour. If one line of treatment has not been effective, alternative drug therapy may provide benefit. If anticancer drugs are considered for pain management, seek expert advice. All anticancer treatments have potential adverse effects—the potential benefits must outweigh potential harms. Patients with poor performance status are unlikely to receive pain relief from chemotherapy.

Chemotherapy and immunotherapy should not be used in the last month of life unless the potential benefits are thought to outweigh the risk of adverse outcomesCrawford, 2021. A trial of targeted treatment options may be appropriate. Prognostication can be very challenging. Consensus specialist input is recommended if there is uncertainty over best treatment options.