• Masahiko Sumitani and Yoshitsugu Yamada.
• Dept. of Anesthesiology and Pain Relief Center, The University of Tokyo Hospital.
• Gan To Kagaku Ryoho. 2011 Jun 1;38(6):977-82.

AbstractCancer-related pain has a wide variety of pathophysiologies. It is well known that many cancer patients suffer from visceral pain, neuropathic pain and bone pain, not only during the terminal phase but also in the active treatment phase. In general, opioids are highly effective against cancer-related pain. It is essential that opioids be selected appropriately based on the pathophysiology of pain, since the analgesic properties of opioids are not homogeneous;the sensitivities of each opioid on neuropathic pain and bone pain differ markedly. In clinical practice, it is also important that potential adverse effects of opioids are taken into account carefully. It has been demonstrated that oxycodone has favorable analgesic potency against neuropathic pain of both malignant and non-malignant origin, such as chemotherapy-induced peripheral neuropathic pain;however, we should be extremely cautious so as to avoid abuse and addiction to opioids when they are prescribed in the active treatment phase. Oxycodone could be effective on refractory bone pain that has a complicated pathophysiological mechanism. Furthermore, it has been reported that oxycodone may have a superior safety profile compared to morphine. Taking these characteristics into consideration, it appears that oxycodone is suitable as a first-line medication for the management of cancer-related pain that comes in a wide variety of pathophysiologies.

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