Pain is one of the most common and intolerable cancer symptoms. It is therefore recommended that palliative care and pain management should be commenced even at the early stages of cancer. For most patients with cancer pain, the World Health Organization′s three-step analgesic ladder can provide adequate pain relief. We need to fully understand how to use the analgesic ladder, how to select opioids, how to titrate the daily dose of analgesics, how to set the rescue doses for breakthrough pain, how to switch opioids when intolerable adverse events appear, how to treat opioid-insensitive pain, such as neuropathic and bone pain, and how to select patients that should be treated with neural blockade. This review focuses on the pharmacological agents currently available for effectively treating cancer pain.
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