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Abstract
Patients with cancer have diverse symptoms, impairments in physical and psychological
functioning, and other difficulties that can undermine their quality of life. If inadequately
controlled, pain can have a profoundly adverse impact on the patient and his or her
family. The critical importance of pain management as part of routine cancer care
has been forcefully advanced by WHO, international and national professional organisations,
and governmental agencies. The prevalence of chronic pain is about 30-50% among patients
with cancer who are undergoing active treatment for a solid tumour and 70-90% among
those with advanced disease. Prospective surveys indicate that as many as 90% of patients
could attain adequate relief with simple drug therapies, but this success rate is
not achieved in routine practice. Inadequate management of pain is the result of various
issues that include: undertreatment by clinicians with insufficient knowledge of pain
assessment and therapy; inappropriate concerns about opioid side-effects and addiction;
a tendency to give lower priority to symptom control than to disease management; patients
under-reporting of pain and non-compliance with therapy; and impediments to optimum
analgesic therapy in the healthcare system. To improve the management of cancer pain,
every practitioner involved in the care of these patients must ensure that his or
her medical information is current and that patients receive appropriate education.