Abstract
This report describes a successful management of severe cancer pain in a 54-year-old woman with advanced angiosarcoma. Daily analgesic therapy had consisted of 90mg pentazocine, im and 0.6mg buprenorphine, im. She was somnolent but in considerable, pain, particularly when moved. When the combination of these drugs no longer controlled cancer pain, the patient was started on oral morphine. Her pain has been controlled for more than 4 months with 4-hourly oral morphine HCl in aqueous solution and adjuvant medication (aspirin and amitriptyline). The dose of aqueous morphine, however, had to be increased from 240mg/day to 4500mg/day to sustain analgesia. In spite of such a massive dose of morphine, she took some cups of coffee and smoked cigaretts every day. She did not complain of nausea, vomiting nor itching. Boredom drowsiness did persist, but this did not prevent her normal activity. She died from sudden upper airway obstruction resulted from the invasion of the cancer.
