Palliative Care & Pain Management: Pain Management After the Hospital Stay

Whether a patient is in the hospital, at home, or in a long-term care facility, effective pain management is an essential part of comprehensive cancer care.

Because hospital stays are usually short, pain related to cancer is most often managed in the home. For some cancer survivors, pain management may not be necessary until the patient has received primary treatment. The doctors on Memorial Sloan Kettering's Palliative Medicine Service provide expert pain management to outpatients who have pain resulting from cancer and some cancer-killing therapies. Non-physical stressors, such as financial, emotional, and spiritual difficulties, may also contribute to pain and are included in the pain management plan.

For these and other reasons, it can be vital to maintain ongoing relationships with physicians and nurses who have specialized experience in managing cancer-related pain.

Management of Chronic Cancer Pain

Pain-relieving medicines can be prescribed to treat various types of pain the patient may experience once he or she has been discharged from the hospital. Depending on the patient's individual needs and preferences, analgesics can be taken orally, transmucosally (held in the mouth briefly until absorbed), rectally, intravenously (by needle into a vein), subcutaneously (injected just under the skin), or transdermally (absorbed through the skin). If needed, Memorial Sloan Kettering's anesthesiologists, who have expertise in pain management, can perform interventions such as nerve blocks or insert patient-controlled analgesia (PCA) pumps that deliver precisely targeted doses of analgesics epidurally or intrathecally. These computerized pumps can be refilled, and medications adjusted, during regular outpatient visits.

Outpatient Pain and Palliative Care

The Palliative Medicine Service provides outpatient clinics at several locations:

Supportive Care Program

The Supportive Care Program of Memorial Sloan Kettering's Palliative Medicine Service provides support to patients who require pain management that extends beyond the hospital stay. The program's acute pain nurses, or APNs, with support from the Palliative Medicine Service interdisciplinary team, consult with patients, caregivers, local clinicians, and community pharmacists, offering their expertise in reducing pain and controlling other symptoms experienced by patients after leaving the hospital.

Counseling Center

The Memorial Sloan Kettering Counseling Center is an outpatient facility designed for the psychological support of cancer patients and their families, providing help for many cancer-related symptoms including pain, fatigue, insomnia, and distress. Often, an approach that combines both counseling and medication may be most the effective. To that end, our doctors in the Counseling Center work closely with Memorial Sloan Kettering's Palliative Medicine Service. Counseling for breast cancer patients is also available at the Evelyn H. Lauder Breast Center, at 300 East 66th Street.

Living Beyond Cancer

People facing the challenges of cancer survivorship can access a variety of support services through the Living Beyond Cancer section of our website. This section includes information about professionally led support groups and counseling; survivorship clinics to manage late effects of cancer and its treatment; recommendations about screening and healthy living; and specialized services to address sexual and reproductive health. We also offer a range of resources to help survivors, families, and friends better understand the complex emotional and social issues that may arise following treatment.

Complementary Therapies for Pain

Complementary approaches to supplement medical pain-control methods include relaxation techniques, meditation, movement therapies, acupuncture, and massage. These techniques can provide relief from acute pain during certain procedures, as well as relief from acute post-procedural pain and some forms of chronic pain.

Memorial Sloan Kettering's Integrative Medicine Service offers individual therapies and group classes using these complementary approaches. Complementary therapies are available to outpatients at the Bendheim Integrative Medicine Center at 1429 First Avenue (at 74th Street). For information and to make an appointment for these fee-for-service therapies, call 646-888-0800.