Persistent or chronic pain in cancer survivors

Persistent or chronic pain in cancer survivors — referral criteria for Chronic pain services.

Eligibility

At least one must be met for the patient to be eligible for referral.

Clinically suspected or confirmed persistent or chronic pain in cancer survivors with initial primary-care work-up completed

Red flags

Indicate urgent (Category 1) referral or emergency assessment.

Rapidly progressive neurological symptoms leading to weakness or imbalance

Suspected cauda equina syndrome (e.g. leg weakness, loss of bowel or bladder control)

Suspected systemic infection

Routine referral criteria

Determine Category 2 or 3 urgency.

Persistent or chronic pain following cancer treatment (e.g. chemotherapy-induced peripheral neuropathy, abdominal visceral pain, neural injury) with all of the following:

longer than 3 months duration with symptoms that impact on daily activities including impact on work, study, school or carer role

ongoing or escalating analgesia needs despite adequate trial of treatment in previous 3 months (exercise and analgesia)

adequate trial of treatment (exercise and analgesia)

at risk of functional or psychological deterioration, or medication dependence

willing to explore living well with pain and is willing to learn to self-manage ongoing pain

Usually managed in primary care

Patients that are currently not willing to explore living well with pain and not willing to learn to self-manage ongoing pain
Patients currently receiving treatment for cancer
Patients currently undertaking another chronic pain management program
Patients that have already completed a multidisciplinary, comprehensive chronic pain management program or service for the same identifiable cause of pain where their clinical symptoms, or their readiness to undertake a chronic pain management program,…
Patients who only want an intervention such as an injection or dry needling
Patients who want to receive services as a compensable patient should not be referred to health service that only provides publicly funded services