Abstract

Pain is probably one of the most common cancer symptoms. In addition to being a major source of suffering and disability, cancer pain is extremely frightening for patients and their families. The authors propose to adjust the World Health Organization (WHO) pain management ladder from its current three-step approach to a more sophisticated five-step algorithm that includes physical and psychological modalities along the entire continuum of care and adds two more steps related to neuromodulative and neurodestructive procedures once the opioids fail. This review discusses the current surgical options for treating cancer pain, focusing on the continuous drug infusion pump currently available and briefly exploring some of the other surgical options for pain management. The introduction of intrathecal opioid administration for intractable cancer pain is considered as one of the most important breakthroughs in pain management. Morphine, the only opioid approved by FDA for intrathecal administration, has been increasingly utilized for this purpose.

• Keywords: Intractable cancer pain, Morphine, Continuous drug infusion pump