Management of cancer pain

About 50 - 80% of all cancer patients experience pain which is due to different reasons, originated at different locations, and showed different levels of intensity. Sometimes the pain is not provoked by the tumor itself but is due to other causes, e. g. disk prolaps. However, normally the pain is caused by the tumor or the metastases. Specialized methods of cancer treatment such as surgery, radiation or chemotherapy provide the most efficient and direct approaches to relieve the patients from their pain. However, this approach normally needs more time than symptomatic pain management. Adequate symptomatic therapy of cancer pain given as transient or permanent treatment leads to rapid pain relief. Based on the type and location of pain, the underlying cause of pain is diagnosed and the most suitable treatment regime is chosen. Basic rules of medical pain therapy according to the WHO pain relief ladder, the regular intake of medicines and a pain survey with individual dose adjustment should be observed. Co-medication with antiemetics and laxatives should also be initiated to prevent side effects such as nausea and constipation. Co-analgetics such as anticonvulsants to relief neuropathic pain should be given early. Pain is always a multidimensional problem, and an interdisciplinary approach should be an integral part of care in cancer patients including not only adequate pain medication but also physical therapy as well as psychological and social support.