| Sumario: | BACKGROUND: The majority of cancer patients with advanced disease have pain. Pain severely impairs health-related quality of life and is the most feared symptom in cancer patients. The quality of palliative treatment of cancer-related pain depends both on knowledge and competence of the health care workers involved, as well as on organisational aspects including a well-developed health services and well-functioning collaboration among health personnel at the different treatment levels. International research as well as national reports emphasize the potential for improving pain therapy for cancer patients in the palliative phase by means of improving all three factors: knowledge, competence and health services organisation. COMMENTS: RCTs of cancer pain control often enroll few subjects, have low methodological quality and involve heterogeneous interventions and outcome measures assessed by different pain assessment tools. This review demonstrates that a significant body of research has failed to produce a clear answer to key questions in the management of cancer pain. The heterogeneity of existing trials precludes meta-analyses for most sub questions. Future trials of cancer pain relief would benefit from common criteria for the reporting of pain response, thus improving the comparability and thereby allowing for meta-analyses.
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