Pharmacologic pain management in gynecologic oncology

An estimated 1,334,100 new cancer cases have been diagnosed in 2003 in the United States, and approximately an estimated 556,500 cancer-related deaths occurred (1). Cancer patients often struggle with several conditions throughout the course of their disease process even in the absence of premorbid illnesses. These conditions result in significant physical, emotional, psychological, spiritual, and social distress. Physical pain with its different manifestations and perceptions is a common symptom. From the patient's point of view or that of a family member or caregiver, pain is perhaps one of the most feared consequences associated with a diagnosis of cancer (2). Moreover, advances in the treatment of cancer generate another consideration concerning pain management since extension of overall survival may result in a number of patients experiencing cancer-related pain for a prolonged period of time: in general, 50% of patients with cancer experience pain throughout their disease process (3) and up to 75% of patients with advanced or end-stage disease report pain, which is described as severe or excruciating in close to one-third of the cases (4).