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Cancer pain: an update of pharmacological approaches in pain therapy

Gralow, Ingrid

Current Opinion in Anaesthesiology: October 2002 - Volume 15 - Issue 5 - p 555-561
Pain medicine
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Purpose of review This review discusses clinically oriented data on advances in pharmacological research of cancer pain therapy carried out during the last year. The aim is to ascertain whether well known guidelines for cancer pain prove to be adequate or require modification.

Recent findings There are alternatives to morphine, which is the standard drug, including oxycodone or methadone, with the problem of equivalence doses in the case of opioid rotation. Depending on the underlying pathophysiological mechanisms, adjuvant drugs are recommended, such as antidepressants and anticonvulsants for neuropathic pain, or bisphosphonates for metastasis bone pain. Current and future research will offer receptor-specific acting new drugs or old drugs under new indications.

Summary The recommendations of the World Health Organization ladder remain the mainstay of cancer pain management. These recommendations, however, are based more on expert opinions than on evidence-based data.

Department of Anesthesiology and Intensive Care, Pain Clinic, University Clinic of Münster, Germany

Correspondence to Ingrid Gralow, Department of Anesthesiology and Intensive Care, Pain Clinic, University Clinic of Münster, Albert-Schweitzer-Str. 33, 48129 Münster, Germany. Tel: +49 251 8346121; fax: +49 251 838497940; e-mail: gralow@uni-muenster.de

© 2002 Lippincott Williams & Wilkins, Inc.