[Pain therapy in palliative medicine].

The large majority of patients being managed in palliative medicine are suffering from incurable, far advanced and progressive cancer. An overall treatment strategy not only includes the treatment of physical symptoms but also integrates the psychological, social and spiritual problems of the patients and his/her relatives. The most stressful physical symptom is pain, which may be so severe as to be intolerable. With the judicious use of opioids and adjuvant substances, this can be managed satisfactorily. The opioid of choice is oral morphine. The value of oral oxycodone and hydromorphone has not yet been fully established, and it remains to be seen what role they will play in the future. These two substances are expected to become available in Germany in 1998.