الفهرس 
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Abstract
Recent studies demonstrate that 50% of patient with early cancer and 75% of patients with advanced cancer experience moderate to sever pain during the course of their disease.
These findings heightened sensitivity towards effective pain control.
Several modalities have been proposed for management of pain in cancer patients.
It is important to make sure that pain related to cancer or its therapy are effectively controlled for many causes:(1) Uncontrolled pain in cancer patient may lead to undesirable pathophysiologic effects as tachycardia, hypertension, myocardial hypoperfusion, and suppression of immunity,
2) Uncontrolled pain leads to inevitable suffering and anguish,
(3) The quality of life may become unaccepted and activity are all compromised.
So, it is important to provide an acceptable pain control with minimal side effects, prevention of breakthrough pain, pain associated suffering as ”anxiety and depression”, together with patient rehabilitation.
As cause of pain is multifactorial, there are many approaches to control pain, so, choosing an appropriate management is complex.
WHO reaffirmed the implementation of analgesic ladder which outlines the titration of non-opioid, opioid, and adjuvant analgesics alone or in combination; the ladder has three steps based on pain intensity and response of that pain:-