[Palliative pain therapy in terminally ill tumor patients]

The treatment of cancer-associated pain in the terminally ill patient requires a vast knowledge of the available treatment modalities, but we also have to be aware of the fact that the continuous education of patients, nurses and doctors about the proper usage of these modalities is of paramount importance. The 3-step ladder proposed by the World Health Organization (WHO) remains the backbone of pain treatment. Adjuvant drugs may add to the analgesic effect, and medications to relief opioid side effects should routinely be prescribed. Local irradiation remains one of the mainstays in painful bone metastasis. Newer systemic modalities to treat skeletal pain such as the bisphosphonates or radionuclides may in the future change some of our current approaches. The treatment of pain in the terminally ill remains a continuous challenge.