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1. Introduction
2. Overview
3. WHO 3-step analgesic ladder (1)
4. International survey of cancer pain
5. UK national cancer pain survey 2000
6. Increase in mod-severe pain 2000-2004
7. Cancer pain is endemic in the developed world
8. Cancer pain in Norway
9. Systematic review of past 40 years (1)
10. Systematic review of past 40 years (2)
11. Systematic review of past 40 years (3)
12. Pain is very common in advanced cancer
13. 2007 EPIC survey (1)
14. So what has been achieved?
15. The problem
16. The science of pain mechanisms and pain control
17. Cancer pain is complex
18. Cancer pain scenarios
19. Aetiology of cancer pain
20. Chronic pain is mediated by immune mechanisms
21. The causes
22. 20th century view of cancer care
23. WHO cancer pain programme
24. Keeping it simple in 1986
25. WHO 3-step analgesic ladder (2)
26. Who 3-step ladder - systematic review (1)
27. Who 3-step ladder - systematic review (2)
28. Who 3-step ladder - systematic review (3)
29. Validation of WHO ladder
30. The ladder and the clock
31. What has impeded progress?
32. The WHO analgesic ladder - Ferreira 2006
33. The WHO analgesic ladder - Eisenberg 2005 (1)
34. Starting severe pain patients on oxycodone (1)
35. Starting severe pain patients on oxycodone (2)
36. Do we need to go through step 2?
37. Problems with words
38. Adjuvants in pain control
39. Molecular mechanism of pain modulation
40. Current molecular neurotransmission targets
41. Rat model for peripheral neuropathic pain (1)
42. Rat model for peripheral neuropathic pain (2)
43. Gabapentin for neuropathic cancer pain
44. Morphine, gabapentin or their combination (1)
45. Morphine, gabapentin or their combination (2)
46. The solution
47. The WHO analgesic ladder - Eisenberg 2005 (2)
48. Mechanism-based ways of treating cancer pain
49. Pyramid of modern approaches to cancer pain (1)
50. Do anti cancer treatments reduce pain?
51. Vertebroplasty for spinal pain
52. Family of therapeutic opioids/opiates
53. How do opioids reduce pain?
54. Are all opioids the same?
55. Today's useful opioids
56. Mucosal absorption of opioids
57. Can opioids do harm?
58. Opioid adverse effect
59. 2007 EPIC survey (2)
60. Opioid therapy for chronic pain (1)
61. Opioid therapy for chronic pain (2)
62. Opioid tolerance and hyperalgesia (1)
63. Opioid tolerance and hyperalgesia (2)
64. Downstream intracellular signaling
65. The A118G polymorphism in opioid receptor
66. Cochrane update on morphine for cancer pain
67. EAPC recommendations for opioids 2001
68. How good is oral morphine?
69. Comparison of morphine and oxycodone
70. Fentanyl vs. morphine - systematic review (1)
71. Fentanyl vs. morphine - systematic review (2)
72. Can opioids be combined?
73. Whose choice matters?
74. Physician attitudes to cancer pain management (1)
75. Physician attitudes to cancer pain management (2)
76. Models of pain management: dogma vs. rationality
77. What else can we offer besides oral morphine?
78. Pyramid of modern approaches to cancer pain (2)
79. Comprehensive modern approach to analgesics
80. Towards a new mechanism-based approach

Topics Covered

• Who 3-step analgesic ladder for cancer pain
• Overview of WHO cancer pain programme
• Cancer pain: a global problem
• UK national cancer patient survey
• Cancer pain is still endemic in the developed world
• Pain characteristics
• Pain in advanced cancer
• 2007 EPIC survey
• What has been achieved?
• The problem
• The science of pain mechanisms and pain control
• Cancer pain is complex
• Cancer pain scenarios
• Aetiology of cancer pain
• Chronic pain is mediated by immune/inflammatory mechanisms
• The WHO resource allocation model
• Validation of WHO ladder
• What has impeded progress?
• What is an 'adjuvant' in pain control?
• Current molecular neurotransmission targets for pain control
• The solution
• Several mechanism-based ways of treating cancer pain
• Pyramid of modern approaches to cancer pain
• Do anti-cancer treatments reduce pain?
• How do opioids reduce pain and are they all the same?
• Can opioids do harm?
• Morphine for cancer pain
• Can opioids be combined?
• Has the WHO ladder altered physician attitudes to cancer pain management?
• Models of pain management: dogma vs. rationality
• What else can we offer besides oral morphine?
• Comprehensive modern approach to analgesics for cancer pain
• Towards a new mechanism-based approach

Links

Series:

• Cancer Pain Management

Categories:

• Cancer
• Clinical Practice
• Neuroscience

Therapeutic Areas:

• Neurology
• Oncology

Talk Citation

Ahmedzai, S. (2009, February 23). The rational use of opioid analgesics for cancer pain - with a critique of the WHO 3-step ladder [Video file]. In The Biomedical & Life Sciences Collection, Henry Stewart Talks. Retrieved May 18, 2025, from https://doi.org/10.69645/DHDH7929.
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Publication History

• Published on February 23, 2009

Financial Disclosures

• Prof. Sam Ahmedzai has not informed HSTalks of any commercial/financial relationship that it is appropriate to disclose.