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Cancer Pain Assessment and Classification
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The Patient with Difficult Cancer Pain

Main regional center for pain relief and supportive/palliative care, La Maddalena Cancer center, via San Lorenzo 319, 290146 Palermo, Italy
Cancers 2019, 11(4), 565;
Received: 12 March 2019 / Revised: 17 April 2019 / Accepted: 18 April 2019 / Published: 19 April 2019
(This article belongs to the Special Issue Cancer Pains)
PDF [227 KB, uploaded 21 April 2019]


Most patients with cancer pain can be managed with relatively simple methods using oral analgesics at relatively low doses, even for prolonged periods of time. However, in some clinical conditions pain may be more difficult to manage. Various factors can interfere with a desirable and favorable analgesic response. Data from several studies assessing factors of negative pain prognosis have indicated that neuropathic pain, incident pain, psychological distress, opioid addiction, and baseline pain intensity were associated with more difficult pain control. In this narrative review, the main factors that make the therapeutic response to opioids difficult are examined. View Full-Text
Keywords: cancer pain; opioids; neuropathic pain; incident pain; cognitive disturbance; addiction; psychological factors cancer pain; opioids; neuropathic pain; incident pain; cognitive disturbance; addiction; psychological factors
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Mercadante, S. The Patient with Difficult Cancer Pain. Cancers 2019, 11, 565.

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