How to Interpret the EAPC Guidelines for the Treatment of Opioid Cancer Pain

If the National Comprehensive Cancer Network (NCCN) Guidelines for Adults with Cancer Pain are a sumptuous American meal, then the European Association for Palliative Care’s (EAPC) recently organized expert-authored Guidelines for the Treatment of Opioid Cancer Pain (updated version, Lancet Oncol 2012,13:e58) presented here is a simple, yet nutritious, European-style fast food — pragmatic and well thought out. Of course, our goal is to produce a “Chinese delicacy” that meets the needs of our patients as soon as possible, which requires a “chef” who not only has basic knowledge and clinical experience, but also fully respects and patiently listens to the suggestions and opinions of frontline practitioners, just as EAPC’s This requires that the “chef” not only have basic knowledge and clinical experience, but also fully respect and patiently listen to the advice and opinions of frontline practitioners, as EAPC colleagues have done in drafting and updating this guideline. Cancer pain is a complex and chronic process, and although the WHO three-step cancer pain treatment guidelines have been promoted for many years, there have been few subsequent clinical studies, and the “paucity” of evidence-based medicine has “surprised” the experts who compiled the guidelines. Therefore, the new EAPC guidelines repeatedly emphasize the need for further research, especially high-level clinical research, to provide more evidence-based evidence for cancer pain. The guidelines also emphasize the principle of individualization of cancer pain relief, with particular emphasis on the relevance, simplicity, and continuity of pain medication selection for patients, reflecting the humanistic philosophy of the guideline writers. This article translates each of the “recommendations” listed in the guideline, while interpreting them in the context of the clinical practice of cancer pain treatment in China, hoping to provide some reading convenience and discussion topics for our busy colleagues, and we hope you will comment on our interpretation when you read them in depth.