[Cancer pain management: good clinical practices, use of strong opioids]

Abstract

Pain prevalence increases during cancer course disease. Cancer incidence is increasing in France, but thanks to therapeutic advances in the specific treatment, cancer has become a chronic disease, often associated with persistent pain. Cancer pain evaluation should be multidimensional. Pain mechanism (nociceptive, neuropathic or mixed pain) should be recognised in order to prescribe appropriate analgesic treatment. Cancer pain characteristics should be defined (baseline and breakthrough pain). Today, a wide range of pain medications, including strong opioids, are available. The use of analgesic combinations is strongly recommended for cancer pain management. Medication characteristics knowledge (pharmacodynamics and pharmacokinetics) is essential and must be associated with a good doctor-patient relationship, to ensure optimal treatment of the painful patient at all stages of the disease.