[Difficulties with using morphine in cancer pain management: Ivorian experience]

Pain is the most frequent functional aspect found with cancers. Pain leads to incapacity in 69% of cases. However, pain is insufficiently handled, especially in developing countries. Pain considerably affects the quality of life of patients, and it imposes adequate care including the use of morphine when it is necessary.

To determine the difficulties to handle pain in particular with the use of morphine in order to propose some solutions.

Prospective study over six months in the Cancerology Unit of Treichville Training Hospital. It includes 120 patients who had questioning and physical examination including pain evaluation by the VAS.

Chronic pain occurred to 96 patients (80%), pain was nociceptive for 48 patients (50%) and 19 patients (20%) had mixed pain. Morphine was relevant in 54 cases but only 27 prescriptions were made. One of the reasons was the fear of some physicians. Only eight prescriptions were respected. Six patients did not respected prescription because of unavailability whereas the remaining mentioned financial reasons as the obstacle. None adverse reaction occurred.

Morphine represents a major tool to handle pain for a patient suffering of cancer. In Ivory Coast, the development of palliative care enables through national workshop to start a campaign in favor of the availability and easy geographical and financial accessibility of morphine (mainly morphine powder) whenever the prescription is required.