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Annals of Oncology 8:S21-S24, 1997
© 1997 European Society for Medical Oncology

Reviews

Current strategies for pain control

S. Ahmedzai

Department of Surgical and Anaesthetic Sciences, Palliative Medicine Section, Royal Hallamshire Hospital Sheffield, UK

Correspondence to. Prof. S. Ahmedzai Department of Surgical and Anaesthetic Sciences Palliative Medicine Section Royal Hallamshire Hospital Sheffield UK

Pain is the most feared symptom for patients diagnosed with cancer. Although our understanding of cancer pain and its management has greatly improved in the past decade, an unacceptably large proportion of patients still do not receive adequate pain relief. Before commencing any form of treatment, patients must receive a thorough assessment in order to define the pain, causes and severity. The recommendations for progressing a patient from step 2 to step 3 of the WHO analgesic ladder are discussed here as well as the choice of strong opioid substitution. An overview of the benefits of considering alternative routes of administering strong opioids, such as the transdermal delivery of fentanyl (TTS fentanyl), and the use of opioid substitution in patients intolerant to the adverse effects of morphine are also included. Finally, newer approaches to relieving refractory pain, such as neuropathic and bone pain, are considered.

non-opioid-responsive pain, opioid choices, opioid rotation, patient assessment, TTS fentanyl


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