[Concept in the treatment of pain in patients with cancers]

Pain in cancer patients is shown to arise in different ways, demanding a flexible approach to treatment. The following procedures can be selected from, depending on the origin of the pain. (1) Systemic analgesia with peripheral or central analgesic agents combined with psychotropic preparation; (2) administration of opioids through peridural or intrathecal catheters (for pain responsive to opioids, but side effects considerable); (3) neurolyses, e.g. epigastric tumors, recurrence of rectal carcinoma; (4) cordotomy, e.g. unilateral pain in plexus infiltration; (5) operations (endoprostheses, bridging osteosynthesis in the case of bone metastases with or without fractures); (6) radiotherapy (strontium in the case of multiple bone metastases of some tumors). Other treatment methods, e.g. administration of karsil or cortisone, as adjuvant therapy require further investigation.