Academic journal article Bulletin of the World Health Organization

The WHO Basic Rules for the Management of Cancer Pain

Academic journal article Bulletin of the World Health Organization

The WHO Basic Rules for the Management of Cancer Pain

Article excerpt

(1.) Cancer pain can, and should, be treated.

(2.) Evaluation and treatment of cancer pain are best achieved by a team approach.

(3.) The first steps are to take detailed history, and to examine the patient carefully, to determine if the pain is:

* caused by the cancer, related to the cancer, caused by anticancer treatment, or caused by another disorder;

* part of a specific syndrome;

* nociceptive, neuropathic, or mixed nociceptive and neuropathic;

(4.) Treatment begins with an explanation and combines physical and psychological approaches, using both non-drug treatments.

(5.) It is useful to have a sequence of specific aims, such as:

* to increase the hours of pain-free sleep;

* to relieve the pain when the patient is at rest;

* to relieve pain when the patient is standing or active.

(6.) Drugs alone usually give adequate relief from pain caused by cancer, provided that the right drug is administered in the right dose at the right time intervals.

(7.) "By mouth": the oral route is the preferred route for analgesics, including morphine.

(8.) "By the clock": for persistent pain, drugs should be taken at regular time intervals and not "as needed". …

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