Prinzipien der pharmakologischen Tumorschmerztherapie

Up to two thirds of cancer patients suffer from severe pain in the final months of life although most could be treated successfully by consistent pharmacological pain management. This review describes the basis of pain classification, differences between nociceptive and neuropathic pain and pain measurement. The use of non-opioid and opioid drugs as well as co-analgesics and NMDA receptor antagonists is summarized. The treatment of breakthrough pain, opioid rotation and the side effects are highlighted. The tables provide a brief overview on dosing and characteristics of particular drugs. However, pharmacological management should always be embedded in a holistic approach comprising appropriate cancer-specific therapies as well as the psychosocial and spiritual needs of the patient.