Pharmacological treatment of cancer pain

Therapies that are effective against the cancer itself, such as antineoplastic agents, radiotherapy and surgery, often also relieve pain efficiently. If these treatments are not sufficient alone or if they cannot be used, pain is managed with medications or regional anaesthesia. Pain medication is increased stepwise (picture ). Treatment is started with a NSAID or with paracetamol, unless these are contraindicated. An opioid is added when the pain becomes more severe (and the ensuing constipation is treated as well).Pain induced by nerve damage is treated with tricyclic antidepressants and/or gabapentinoids.