Pain is one of the cardinal presenting symptoms in cancer patients and often seems to progress in the natural history of the disease. In light of the past neglect of this problem, it is becoming crucial for clinicians and researchers in the fields of oncology, pain management, and others dealing with this patient population to have a thorough understanding of the often complex pain syndromes that are relevant to managing cancer. In this article we briefly review the important topics related to cancer pain syndromes with some emphasis on those that typically generate localized pain.

Management of cancer pain has made sidnificant progress in recent years, partly due to the Agency for Health Care Policy and Research (AHCPR) guidelines, but mostly it seems to be due to the death and dying movement in the world. However, cancer pain on occasion poses significant problems and needs accurate diganosis and appropriate intervention. Pharmacotherapy remains the mainstay of treating cancer pain. Most cancer pain syndromes present with moderate to severe pain, associated with several comorbid problems necessitating the multidisciplinary approach to optimally treat it. The psychologic factors associated wth serious illness, terminal prognoses, and dying complicate the scenario even more as compared with that of nonmalignant pain. Although such patients are entitled to more aggressive analgesic therapy, it is unfortunate that this is not achieved in a significant percentage of cases. In this review, we address some of the above issues and attempt to summarize the traditional pharmacologic therapies highlighting their modern modes of implementation in cancer pain management. Special emphasis on the state-of-the art innovations in this field wil be noted.