Pain Management in Cancer Patients

Baik, Seong Wan

Abstract

In 1990, WHO developed the analgesic ladder for rational titration of medication for cancer pain, because 50% of patients with cancer and 75% of those with advanced malignant disease will likely experience moderate to severe pain according to the report of Agency for Health Care Policy and Research(AHCPR). Actually, However, about 62% of cancer pain are not adequately controlled for several reasons, such as inappropriate dosage of analgesics, strict regulation of narcotics, physicians' indifference to cancer pain, and lack of knowledge for pain assessment in Korea. In this chapter, I would like to introduce techniques to relieve pain in cancer patients using some kinds of analgesics including narcotics, adjuvants, and verve blocks. By using medications and nerve block, more than 95% of cancer pain can be relieved effectively. One may be unfamiliar with the fact that cancer pain is not single isolated entity itself, but has multiple etiologies that may or may not be directly related to the cancer itself. This fact has resulted in the awareness that the treatment must be directed toward the perceived etiology of pain once it is identified. Pain does not occur in a vacuum ; the psychological manifestations of pain must be treated as well as any possible side effects of the treatment. With regards to cancer pain, this is generally stressed in all fields of medicine, particularly in the field of pain medicine.