Cancer Bone Pain Multimodal — FRCA Final MCQ

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ModeratePain MedicineCancer Bone Pain MultimodalFRCA Final

Metastatic prostate cancer: bone pain on MR morphine 120 mg BD + breakthrough. Pain 7/10. Best next step?

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Correct answer: C — Add NSAID and consider bisphosphonate or radiotherapy

Cancer bone pain is opioid-semi-responsive. Multimodal: add NSAID, bisphosphonate/denosumab, palliative RT (single fraction effective 60-80%). Address specific pain mechanism rather than simply escalate opioids.

Reference: NICE – 2023 – NG46 Bone pain; FPM – 2023