ABSTRACT
This chapter presents a case study of pat, who is a 36-year-old woman, married, with two sons aged 12 and 9 years. She had problems with her bowels for several months before some rectal bleeding made her see her general practitioner. Investigations revealed a carcinoma of the sigmoid colon with liver metastases. She copes by maintaining a level of denial and refuses to tell her sons. Pains can have many causes, and several pains can co-exist, sometimes in the same site. Each patient therefore needs an individualised analgesic staircase. Some analgesics work directly by blocking pain pathways – these are primary analgesics. The World Health Organization staircase uses non-opioids, weak opioids and strong opioids as the three steps.
