Opioid analgesics for cancer pain in primary care

Each year, around 140,000 people die from cancer in England and Wales, about one-quarter of them in the community. Two crucial goals in the palliative care of such people are to enhance quality of life and control symptoms. Of particular importance, morethan two-thirds of patients with cancer will require opioid analgesics to control pain. Since many patients with cancer, including those with advanced disease, aim to spend more time at home rather than in hospital, the primary care team has an important role in managing pain. The team, supported by community clinical nurse specialists and specialist palliative care units, is often responsible for initiating analgesic therapy and for ongoing assessment of patients' pain and analgesic requirements. Here we discuss key issues in using opioids for cancer-related pain in primary care.