Cancer pain management modalities and positioning of oxycodone

Cancer pain management is centered on opioid therapy. In Japan, 3 types of strong opioid are available for treatment; therefore it is important to use them according to the characteristics of each drug and dosage form. Particularly, oxycodone is suitable as first-line choice of opioid, which can also be employed as opioid switching when symptoms of the central nervous system is manifested following the use of oral morphine. Furthermore, opioid responsiveness should be taken into account when opioid therapy is carried out; assessment of the analgesic effect is particularly important. Recently, we tried to select suitable treatment modalities by speculating on the pathologic conditions of pain relative to the responsiveness to morphine and causes of pain. In the case of pain with low response to morphine, it was possible to attain good pain control not only by opioid therapy but also by a combination of opioid therapy and nerve block therapy. In cancer pain treatment, appropriate assessment of pathologic conditions of pain and selection of adequate and accurate treatment modalities are essential for improvement of the effect of pain relief.