Current issues in the management of cancer pain: Memorial Sloan-Kettering Cancer Center.

Recent attention to the management of cancer pain in the mass media (TV, books, newspapers) and the medical press provides ample evidence to suggest that many cancer patients are not receiving appropriate therapy for their pain. Since cancer therapy is often not curative, only palliative, specific attention to the management of pain in such patients is essential. However, the management of cancer pain requires a specific approach and expertise. Narcotic analgesics are the mainstay of therapy in the management of such patients, yet physicians lack sufficient knowledge of narcotic pharmacology to use these drugs appropriately. Recent controversy has arisen in 3 specific aspects of narcotic drug therapy: 1) the choice of a narcotic drug and its method of administration; 2) the development of tolerance, and 3) the risk of substance abuse, drug dependence, and addiction.