Journal
JOURNAL OF PAIN AND SYMPTOM MANAGEMENT
Volume 29, Issue 1, Pages 41-54Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jpainsymman.2004.08.004
Keywords
cancer pain; WHO; analgesia; history of pain management
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The origins of the WHO Cancer Pain Relief Program (the Analgesic Ladder) and its research basis in two very different research traditions, one at Memorial Sloan-Kettering Cancer Center in New York, the other at St. Christopher's Hospice in London, are discussed. The Sloan-Kettering group emphasized precise relative differences in analgesic effects of various drugs, whereas Twycross at St. Christopher's used patient well-being as the crucial benchmark. Despite these differences, both traditions presented evidence of the safe and effective use of strong opioids for cancer pain relief, in a selling of individualized attention and close physician monitoring. The success and limitations of the Ladder as a global health policy are briefly addressed. (C) 2005 U. S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.
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