Pain treatment in cancer patients - an update

Pain is one of the most common symptoms in cancer patients. Its intensity and character correlate with the aetiology, site and stage of the cancer, as well as the extent of metastases. Pathophysiologically, nociceptive, neuropathic and mixed (nociceptive and neuropathic) pain syndromes can be differentiated. In addition to chronic pain, some patients also suffer from cancer-related breakthrough pain. To ensure adequate pain control in such patients, a detailed medical history and a meticulous physical examination, together with a broad knowledge of the pain syndromes presenting, and also multidisciplinary pain management strategies, are essential. In addition to analgesics administered in accordance with a rigid time schedule, proper dosing, individual dose titration and the prescription of co-analgesics are important. In addition to the basic therapy, adequate medication must also be available to the patient for the treatment of possible breakthrough pain. Furthermore, since the quality of life of cancer pain patients may be compromised by other cancer- and/or treatment-related symptoms such as constipation, fatigue, vomiting, etc. a comprehensive therapeutic approach is needed.