Cah Anesthesiol. 1993 ; 41(6): 621-4.

Cancer pain management.

Charlton JE.

Pain Management Unit, Royal Victoria Infirmary, Newcastle upon Tyne, Great Britain.

Cancer pain can be relieved with oral analgesics in most cases but 10 to 20% of patients do not respond. They are presently called opioid-resistant. While mild pain can be treated by paracetamol and non steroidal anti-inflammatory drugs, strong opioids are needed frequently. The author believes that there is no place for the weak opioids in cancer pain treatment. With strong opioids side effects are frequent, whether given orally (as is to be tried whenever possible), rectally or by other routes. Epidural or spinal delivery needs a special support system. Associations with steroids, antidepressants or other drugs are recommended. Nerve blocks and neurolytic procedures and methods such as transcutaneous nerve stimulation and acupuncture can be helpful.