Opioid Titration Order Sheet or Standard Care in Treating Patients With Cancer Pain

DISEASE CHARACTERISTICS: * Histologically confirmed carcinoma * Cancer-related pain requiring fixed-dose opioid therapy * Has received ≥ 1 week of fixed-dose opioid therapy AND meets any of the following criteria: * Inadequate pain control as defined by the patient * Requires 2 or more rescue doses per day * Requires adjustments in pain regimen (either fixed or breakthrough dosing) * No pain crisis that requires hospitalization or immediate anesthetic or neurosurgical intervention * No predominantly neuropathic pain (e.g., peripheral neuropathy) as assessed by the treating physician PATIENT CHARACTERISTICS: * ECOG performance status 0-2 * ANC \> 1,500/mm³ * Platelet count \> 100,000/mm³ * Serum bilirubin \< 1.5 mg/dL * Serum creatinine \< 2.5 mg/dL * Not pregnant or nursing * Negative pregnancy test * Fertile patients must use effective contraception * Nutritional, pulmonary, and cardiac status must be considered adequate to tolerate the proposed study therapy * Must be available for active follow-up * No documented active psychiatric disorder (i.e., psychosis or major depression) that would preclude informed consent or the patient's ability to comply with study procedures * No significant infection * No concerns about compliance with medication regimens or medical follow-up * No excessive alcohol use PRIOR CONCURRENT THERAPY: * See Disease Characteristics * Concurrent chemotherapy or radiotherapy allowed