Defining refractory pain in cancer for clinicians and researchers

Abstract

Managing pain in people with cancer remains a challenge, especially in those referred to as having refractory pain. But what is refractory or intractable pain? Until there is a standard definition there is the risk that: a) clinically, new medications are continuously added, each with diminishing returns in reducing pain, and each with an increasing likelihood of toxicity as the only noticeable change; and b) in research, there will be differing baselines for the operational definition of refractory, making it difficult to adopt the findings into practice, or to compare clinical trials in any systematic way.