[Therapy of cancer pain--a comprehensive therapy concept].

Abstract

A comprehensive conception for cancer pain treatment is presented. The medical analgesic drug therapy representing the main point of this conception is applied as a three steps analgesic ladder as recommend by the WHO. This kind of therapy enables an individual adaptation resp. increase of the analgesic intensity by the use of non narcotic analgetics, weak and strong opioids as well as adjuvant drugs. Besides the explanation of the principles of its application and some detailed instructions for the dosage of several drugs, possible side effects and interactions are mentioned as well as some examples for its clinical application are quoted. A further increase of the analgesic intensity is reached by the local intraspinal application of morphine. For this purpose epidural and intrathecal long-term catheters are used. Also in these cases dosage, side effects and complications are mentioned and the possibilities and advantages of the continuous analgesia with implantable systems (pain ports) and external portable or implantable pumps are discussed. Furthermore the role of the neurolytic blocks, neurosurgical treatment and radiation therapy within this conception is mentioned.