الفهرس 
CHAPTER 1Only 14 pages are availabe for public view
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Abstract
Pain is one of the most common symptoms experienced by cancer
patients. The greatest fear among these cancer patients and their
families is unrelieved pain. The aim of treatment is to enhance the
quality of life by providing adequate pain control, not hasten or delay
death.
Patients can present with different types of pain which can be well
managed, in most of cancer patients, with the use of conventional
analgesics and adjuvants according to the principles of the World
Health Organization (WHO) analgesic ladder for cancer pain relief.
The remaining group of cancer patients with unrelieved pain or those
experiencing intolerable side effects of conventional analgesics may
benefit from some form of interventional strategies for pain
management. This can be considered as Step 4 of the analgesic ladder.
Effective interventional management of cancer pain depends greatly
on proper patient assessment and selection. Actually it was found that
poor assessment of pain was the major barrier to good pain
management.
Interventional strategies comprise two categories: ablative and
augmentative modalities. Ablative modalities involve blocking
nociceptive transmission by neurolytic injections or surgical lesions.The goal is to use chemicals (e.g., phenol, alcohol), or a scalpel to
destroy nociceptive pathways and thereby achieve pain relief.
Augmentative modalities comprise infusional and electrical
stimulation techniques. Medication infusion has emerged as a major
resource in cancer pain management, whereas electrical stimulation
plays a relatively minor role. Much of the growing interest in infusion
therapy results from improved technology for continuous infusion,
using epidural, intrathecal catheters connected to external infusion
pumps, subcutaneous injection reservoirs, or implanted programmable
infusion pumps.