ABSTRACT
This chapter discusses the main obstacles limiting the design and execution of clinical trials in cancer pain. It focuses on three main areas of concern: the proper staging of cancer pain, the design of trials on narcotic analgesics, and the design of trials on adjuvant drugs. Staging systems have proven to be an invaluable resource for research and treatment of cancer. They provide a common language for a rapid and reproducible description of patient characteristics and for the comparison of new therapies. Opiate drugs are among the oldest remedies of mankind. While morphine and its congeners continued to be used to alleviate the pain of cancer patients, the fashion in which these drugs were used was based on incorrect patterns of practice. Opiate analgesics are the important drugs for the treatment of chronic pain. An adjuvant drug should be able to increase the analgesic effect of narcotics; decrease the toxicity of narcotics; or improve the associated symptoms of terminal cancer.
