CONSULT REQUEST GUIDELINES                                                                         Print

Cancer Pain

Suggested Pre-Referral Evaluation and Management Guidelines Causes of pain in cancer patients can be due to:
1)Primary disease: e.g. invasion, obstruction, distension, or compression.
2)Cancer treatment: e.g. neuropathic pain from chemotherapy or radiation therapy, or postsurgical pain syndrome.
3)Unrelated to cancer: e.g. low back pain from degenerative joint disease etc.
Interventional treatment of cancer pain along with comprehensive medical management has resulted in lower pain scores, reduced medication side effects and a positive trend toward improved quality of life and survival when compared with comprehensive medical management alone in patients with significant cancer pain.
Suggested Additional Test/Management Prior to Specialty Visit World Health Organization Three Step Ladder:
Step1:Mild Pain 1-3/10-non-opioids (ASA, NSAID's)
Step2:Moderate Pain 4-6/10-weak opioids Acetaminophen/codeine etc
Step3:Severe Pain 7-10/10 Strong opioids Morphine, hydromorphone etc
Step4:Referral to the Back and Pain Center for
  • Intraspinal or epidural administration of opioids, local anesthetic, and other agents
  • Peripheral nerve blocks +/- indwelling catheters
  • Neurolytic blocks such as celiac plexus, hypogastric or ganglion impar
  • History of Cancer including sites of metastasis, prognosis
    Copies of available investigations (Plain films, CT, MRI, Bone scan&.)
    Relevant past medical history
    Referral to U of M Back & Pain Center

    For more information regarding our program and what we offer please visit our website at U of M Back & Pain Center (
    Patient Education/Information (includes preps) U of M Back & Pain Center 
    Appointment Timeframe 1-3 days 
    How to Get Results to Consultant UMHS Patients: See MiChart
    External Patients: Hand carry non-UM records to visit or fax to 734-936-6585
    Clinic Contact Information Physicians: 800-962-3555
    Patient: 734-615-7246
    Clinic Location Sites Alfred Taubman Health Care Center
    Brighton Health Center
    Burlington Building
    Canton Health Center
    East Ann Arbor
    Northville Health Center
    UM Consulting Physician U of M Back & Pain Center Faculty
    Revised on: 12/29/2014



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