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tvpjournal.com | January/February 2016 | Today's VeTerinary PracTice elemenTs oF oncology Peer reviewed 47 controlling cancer pain should always be part of a cancer treatment plan. Pain management should be implemented as soon as possible following diagnosis to address existing pain and prevent onset of new pain. even if the patient has no outward, objective clinical signs of pain, the practitioner should assume that any tumor has the potential to cause subclinical pain, and pain management should be considered as part of the therapeutic plan. This is an important concept in the veterinary profession because our patients are unable to communicate their level of pain directly. TYPES OF CANCER PAIN Tumors can present in any part of the body, resulting in pain. in the frst article of this 2-part series, Pathophysiology & Assessment of Cancer Pain (may/June 2015; available at tvpjournal.com), we described 2 mechanisms for cancer pain: 1. endogenous chemical irritation 2. direct tumor invasion with compression of normal tissues. in addition, cancer pain can result from cancer therapies, such as surgery, radiation therapy, and cytotoxic chemotherapy. TYPES OF PAIN MANAGEMENT optimal cancer pain management is determined by the type of cancer and the owner's goals for treatment. Broadly, 2 potential treatment pathways exist in veterinary oncology, both of which may employ analgesic drugs, radiation therapy, surgery, chemotherapy, or a combination of these modalities (Figure 1): strategies for managing cancer Pain in dogs & cats Part 2: Definitive & Palliative ManageMent of CanCer Pain Nicholas Rancilio, DVM, Diplomate ACVR (Radiation Oncology); Jeff Ko, DVM, MS, Diplomate ACVAA; and Christopher M. Fulkerson, DVM, MS, Diplomate ACVIM (Oncology) Purdue University Welcome to elements of oncology —a column that addresses the many components of diagnosing, managing, treating, and monitoring veterinary cancer patients. This new column begins with a series of two articles that describe strategies for cancer pain management in dogs and cats, with an overall goal of raising awareness among the veterinary community about treating cancer pain early and recognizing that cancer pain can be considerably different from other types of acute or chronic pain. Figure 1. goal-oriented cancer treatment decision-making tree. RACE-AppRovEd CE CREdiT ARTiClE Visit vetmedteam.com and take the continuing education quiz that accompanies this article to receive RACE- approved CE credit.