Implementing therapy with opioids in patients with cancer.

PURPOSE/OBJECTIVES To review strategies to optimize the management of chronic pain in patients with cancer, with an emphasis on the role of opioid analgesics. DATA SOURCES Published research, articles from a literature review, and U. S. statistics. DATA SYNTHESIS Treatment for cancer pain remains suboptimal. With the therapies currently available, as much as 90% of cancer pain can be controlled. Opioid analgesics are an important component of pain management in patients with cancer. CONCLUSIONS The management of cancer pain is a challenging endeavor that requires an understanding of the etiologies of cancer and the types of pain they can produce. Opioid analgesics are a mainstay of treatment for cancer pain. New drug formulations, delivery systems, and strategies, particularly opioid rotation, are available to optimize cancer pain management. IMPLICATIONS FOR NURSING Opioid rotation may be useful for opening the therapeutic window and establishing a more advantageous analgesic-to-toxicity ratio in patients with cancer.