RT Book, Section A1 Shih, Kaoswi K. A1 Dev, Rony A1 Dalal, Shalini A2 Kantarjian, Hagop M. A2 Wolff, Robert A. A2 Rieber, Alyssa G. SR Print(0) ID 1190840650 T1 Pain Management and Symptom Control T2 The MD Anderson Manual of Medical Oncology, 4e YR 2022 FD 2022 PB McGraw Hill Education PP New York, NY SN 9781260467642 LK accessmedicine.mhmedical.com/content.aspx?aid=1190840650 RD 2024/03/28 AB KEY CONCEPTSPatients with cancer experience multiple symptoms that are often under-reported and not alleviated. Symptoms are often interrelated and can be both physical and/or psychological.Pain expression can be modified by cognitive and psychological factors associated with advanced disease or the dying process.A thorough psychosocial history, assessment of mental status, and screening with risk assessment tools for nonmedical opioid use is critical before prescribing opioid analgesics.Fatigue is the most common symptom in patients with advanced cancer and its treatment is challenging in later stages of disease. Patients and families benefit from education about the burdens of both physical and emotional fatigue. It can be helpful to modify daily activities and rest to accommodate for symptoms of fatigue as well as optimizing nutrition and hydration.Dyspnea is often an indicator of poor prognosis in advanced cancer. Initial management includes treating underlying causes medically when able. Palliative measures to reduce the sensation of air hunger include low flow supplemental oxygen for those with hypoxemia, opioids, or corticosteroids.Anorexia and weight loss are a result of systemic inflammation and inadequate caloric intake because of cancer and are often difficult to reverse. Psychosocial support for cachectic patients and their family caregivers can help diminish patient-family distress.Advanced care planning can decrease anxiety and suffering of patients and families as well as ensure autonomy for patients, especially if they become unable to express informed consent. However, it is an ongoing process that is best started early, revisited periodically, and incorporates room for change owing to unforeseen changes in the patient's clinical condition.