A 65-year-old female with known metastatic breast cancer is experiencing severe, uncontrolled bone pain despite regular use of oral extended-release morphine. She reports breakthrough pain several times a day requiring frequent doses of immediate-release morphine, with diminishing effect. Her performance status is declining due to pain. Which of the following is the most appropriate next step in managing her pain?
✓ Correct Answer: Option A
The patient has escalating pain despite current opioid therapy, indicating inadequate analgesia. The first step is typically to increase the dose of the long-acting opioid, adjusting based on breakthrough pain requirements. Adding adjuvant therapy or switching opioids might be considered if dose escalation fails or side effects are intolerable.