Pain associated
with cancer is often under treated especially in the developing
countries where there are problems of poor economy, poor purchasing
power of the citizens, absence of effective national health insurance
schemes, poor manpower, fake adulterated and expired drugs, poor
drug storage conditions; adverse temperature conditions combined
with poor power supply which may affect drug efficacy. There is
also poor understanding of the physiopharmacology of cancer pain
management by health care providers. Assessment of the severity
of the pain by location, oncological type, as well as psychosocial,
emotional and environmental factors are necessary. The pain often
occurs from malignancy, from procedures done to diagnose, stage
and treat the malignancy, and from the toxicities of therapy used
in treating the cancer. The first priority of treatment is to
control pain rapidly and completely, as judged by the patient.
The second priority is to prevent recurrence of pain. Analgesic
drugs are given ‘by the ladder,’ ‘by the clock’ and ‘by the appropriate
route’ using the analgesic ladder guideline proposed by the World
Health Organization (WHO). The pharmacological aspects of various
drugs used in the management of cancer pain are discussed.
