Morphine is Still the Standard Opioid in the Treatment of Cancer Pain

Abstract

  Management of pain in cancer patients according to the WHO ladder using morphine is still the standard in treating cancer pain, even after both oxycontin^® and fentanyl patch became available in Japan. One reason is that rescue opioids other than morphine are not available. Immediate opioids are useful not only in treating breakthrough pain, but also in assessing whether the cancer pain is refractory to opioids or not. Although opioid rotation is sometimes performed to control side effects, it should be used only after appropriate side effect treatment. If the side effects are well controlled, side effect control with other opioids is much easier.