[Pain therapy in gynecologic neoplasms].

A great number of patients with gynaecological malignant diseases suffer from severe pain, caused, for example, by bone metastases of breast cancer or tumour infiltration of the pelvis and the lumbar plexus in uterine cancer. Several methods of treatment are available depending upon the origin of pain. It is possible to achieve pain relief by radiotherapy or by cytostatic therapy. Sometimes, anaesthesiological and neurosurgical measures are successful, but the most important method is treatment with analgesics. Strong opioids are given, if pain relief is insufficient under treatment with non-narcotic drugs or weak opioids, like codeine. Morphine and other strong opioids are not reserved for pain control only in terminally sick women, as they can be administered successfully for long periods without severe side effects. If possible, the oral route should be selected. If vomiting occurs, or if patients are unable to take oral medication, morphine can be given peridurally, intrathecally or by infusion. Often, an additional treatment is necessary with different medicaments like tricyclic antidepressants and corticosteroids.