Side Effects of Nociceptive Cancer Pain Treatments in Adults

  • Ivan KrakowskiEmail author
  • Aline Henry


Pain is unfortunately a frequent symptom of cancer, especially in the advanced stages of disease. Its treatment must be integrated into a comprehensive supportive care approach, which itself must be conducted in parallel with specific therapeutic cancer agents, if indicated, and then integrated into the process of palliative care in the advanced phase.

Several classes of pain killers are available:
  • Nociceptive pain medications use non-opioid analgesics, weak opioids, and strong opioids, described in the three levels of the WHO ladder.

  • “Pure” neuropathic pain is treated by different drug classes, at least in the front line, such as antidepressants, antiepileptics, and some anesthetics such as ketamine. The analgesics in the WHO ladder, including opioids, are generally less effective for this indication, but they, as well as nondrug treatments, will be tried in case of refractory pain.

For the two types of pain, analgesics are often used in combination with co-analgesics (anxiolytics, corticosteroids, anti-osteoclast inhibitors, antispasmodics, etc.).

It is obviously important to know the main side effects of these different drug classes, in order to prevent them, to inform patients of their possible occurrence, and thereby to promote better compliance. The problem of compliance is indeed particularly acute in the area of pain therapy because patients want to use pain as an indicator of a possible disease progression or of an expected response to specific treatments of cancer, and they fear the side effects of analgesics in general and opioids in particular. The main side effects of analgesics are discussed in this chapter.


Cancer Pain Side effect Pain killer Analgesic 


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Supportive Care DepartmentInstitut BergoniéBordeauxFrance

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