Pain control in advanced and recurrent head and neck cancer.

The treatment of head and neck cancer patients with persistent severe pain often requires a multidisciplinary approach. Accurate documentation of pain frequency, intensity, and location must precede therapy. Medical regimens, as with methadone and Dexedrine, are often effective and should be tried first. If pain is in the trigeminal nerve distribution, local nerve block procedures may provide additional relief. Patients with intractable pain even after medical and nerve block procedures should be considered for a neurosurgical procedure. Percutaneous radiofrequency thermocoagulation of the trigeminal and glossopharyngeal nerves offers low risk, effective pain control in debilitated cancer patients.