[Treatment of pain in cancer patients]

Patients experiencing constant pain continue to receive less than optimal treatment. In the case of cancer pain in particular, adequate therapy is a must. On the basis of the WHO analgesic ladder, nonopioids and opioids of varying potency must be applied as required, together with antiemetics, laxatives, gastric-protective preparations and bisphosphonates to ameliorate side effects. A particular problem in the treatment of cancer pain is the suddenly occurring stress and perforation pain. This can be reduced with fast-acting opioids such as the fentanyl stick. If the patient does not respond adequately to any of the noninvasive methods, local anesthetics and opiates applied via an i.v. pump system that permits bolus application and spinal and epidural methods have proven useful.