Diagnosis needs an understanding of pathology, neuroanatomy and referred pain, and patterns of metastatic spread. Needless to say, recognition of the concept of total pain is also important in planning treatment and allaying the patient's suffering. From a pharmacological point of view, pain in cancer falls into three categories. 1 Opioid responsive pains visceral pain - prescribe opioid. Morphine alone is not the panacea for all cancer pains.
Adjuvant therapy is often necessary, depending on the nature of the pain.
These are now available in most districts and are principally run by the anaesthetic service. Pain relief clinics have a remit for pain control in non-cancer and cancer patients. For cancer patients, pain relief clinics are useful in diagnosis and management of neurogenic pain and pain uncontrolled by radiotherapy or opioids. Anaesthetists associated with palliative care units or hospices are always ready to advise on difficult pain problems.