Background: Pain is a symptom of both physical and psychological disorder in patients. Pain may be acute or chronic. Chronic pain can also be the consequence of progressive diseases such as cancer. Cancer pain can be defined as a complex sensation that reflects both damage to the body and the body's response to the damage. Proper pain management is crucial in the overall care of patients. The doctor-patient ratio is still low in Nigeria according to World Health Organization (WHO). 2012, we have 1:3500 doctor-patient ratio as against the standard 1:600, but that of nurse-patient is better, 1:30 as against WHO standard of 1:6, however more nurses are needed to meet the need of the rising population of Nigeria. Incidence of cancer is rising worldwide and majority of the advanced cases occur in the developing countries like Nigeria. In order to uphold the standard of cancer pain management in our patients, active participation of the nurses is essential. More importantly all health professionals need to serve as advocates for adequate cancer pain control and should ensure that pain treatment is based on ethical principles and evidence-based standards. However nurses play a critical role in effective pain management because they have more contact time with patients in any healthcare setting. This vantage position gives the nurse a unique privilege to identify patients who have pain, assess the pain and its impact on the patients and their family members, thus initiate actions to manage the pain and evaluate the effectiveness of those actions.

The immune system is central in the body's defense against non-self. Immunoglobulins and acute phase proteins have been reported to play active roles in carcinogenesis. This prospective longitudinal study was carried out to determine the state of humoral immunity in Nigerian oral cancer patients relative to controls. Twenty newly diagnosed untreated cases of oral squamous cell carcinoma recruited from our centre were included in the study. The controls included 20 apparently healthy and HIV negative volunteers. Serum immunoglobulin classes and acute phase proteins were measured using immunoplates. IgA and ceruloplasmin showed statistically significantly elevated levels in the patients compared with controls, while increases in IgM and IgG were insignificant. The raised levels suggest a role for immunoglobulin A and ceruloplasmin in the mechanisms involved in oral cancers. Findings from this study are similar to that reported elsewhere in the literature. Further work is needed to ascertain the role and usefulness of immunoglobulins and acute phase proteins in staging, disease monitoring, therapy and prognostication.

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