The therapy of cancer pain and its integration into a comprehensive supportive care strategy

By the beginning of the 21st century cancer will claim over nine million lives per year. Of these patients, 80%-90% will experience pain at some time during the course of their disease. The management of cancer and the associated pain syndromes is likely to cause a massive drain on resources, making it imperative that we use the resources available to maximum efficiency. In the past decade progress has been made in the understanding of cancer pain and how best to manage it. However, this area of cancer therapy continues to be surrounded by much controversy, particularly the availability and use of strong opioids. Additional measures are required to ensure that no patients are left to suffer the burden of cancer pain. These include: strongly improved education of all healthcare professionals in cancer pain and cancer pain therapy; academic affiliation--university chairs in palliative/supportive care securing education of the coming generations of medical doctors and nurses; improved legislation concerning opioids in many societies through systematic influence of politicians and healthcare decision makers; re-allocation of resources for cancer treatment programmes from the curative to the palliative/supportive treatment spectrum; re-defining myths concerning cancer, pain and opioid consumption, both among healthcare workers and in societies in general. The media will play a crucial role in this process. Revising the way in which our resources are allocated and providing all patients access to individually tailored treatment care packages are strategies that could be adopted for future supportive care of cancer patients.