Introduction

Regular pain assessment and pain management should have the highest priority in the routine care of the patient with cancer. Between 60% and 80% of patients with advanced cancer will need pain treatment. Pain is also a problem for many patients earlier and intermittently during the course of their disease. In addition, cancer survivors who are cured of their cancer may have persistent chronic pain as a result of the disease or its treatment.

When pain is present, the quality of life of patients and their family members is adversely affected. However, the majority of patients with cancer-related pain can obtain pain relief if the pain is adequately assessed and appropriate treatment is provided. Numerous guidelines for the management of cancer pain have been endorsed by governmental organizations, professional associations, and the World Health Organization (WHO). Research studies evaluating the WHO's guidelines for cancer pain relief (1,2) indicate that 70% to 90% of patients obtain good pain relief when this protocol for oral analgesic medications is followed (3–6). Other pain management therapies can provide pain control when oral analgesics are not effective.

In spite of the availability of effective pain treatments, multiple studies document undertreatment of pain (7–10). A study completed in the Eastern Cooperative Oncology Group (ECOG) surveyed more than 1300 outpatients with recurrent or metastatic cancer (7). A total of 67% of the patients had pain or were being treated for pain with daily analgesics. Among the patients with pain, 42% were prescribed analgesics that were less potent than those recommended by the WHO guidelines.