Excess nociceptive pain in palliative care

Managing patients' pain is a major concern in healthcare establishments particularly in cancer patients for whom pain varies according to the disease and its stage. First and foremost pain intensity must be assessed according to the WHO grading system to guide the choice of molecule and route of administration. A number of studies have shown a certain reluctance to use morphine in cancer patients suffering from pain but more recent studies tend to demonstrate an improvement in pain management. Morphine therapy requires gradual adaptation of dosage and monitoring is essential due to the many undesirable side effects. This paper reviews the pathophysiology of excess nociceptive pain in oncology and the use of morphine in the management of this pain.