The most common symptom of cancer patients is cancer pain. According to incomplete statistics, 70% of tumor patients are accompanied by pain at different stages of the disease. Relieving pain can not only alleviate the mental and physical torture suffered by patients and improve the quality of life, but also facilitate the control of the disease and further treatment, and ultimately prolong the survival period of patients. However, if the medication for pain treatment is not standardized, it will cause patients to have adverse reactions and even have counterproductive effects. So, how can cancer pain patients cooperate with doctors to control pain better and get good quality of life? First, standardized pain relief “three-step ladder” In the early 1990s, the World Health Organization (WHO) put forward the “three-step ladder therapy” for cancer pain, which has been widely accepted all over the world. It has been proved that standardized medication can help the majority of patients get rid of cancer pain. Depending on the degree of pain, non-steroidal anti-inflammatory drugs (NSAIDs) (the first step), weak opioids (the second step) and strong opioids (the third step) are applied individually or in combination, and the dosage is gradually increased from weak to strong. It is common to start with the first step and begin the next step only if standard previous step therapy is not effective. Second- or third-step pain relief may also be used directly, depending on the condition. First-step pain medications can be used in conjunction with second- and third-steps, respectively. 1. First-step painkillers: mainly for mild cancer pain, especially effective for patients with bone metastases. Representative drugs include aspirin, ibuprofen and fusolin. Aspirin, 25-60 mg per time; or paracetamol, 0.25-0.5 g per time; or analgesic tablets, 1-2 tablets per time can be used. In addition, ibuprofen (fenbendazole), propoxyphene tablets, etc. can also be chosen. Second-order painkillers: mainly for moderate cancer pain, representing drugs such as tramadol, codeine and prednisolone. Codeine, 30～60 mg per time; or aminophenetidine tablet, 1～tablet per time; or prednisolone, 30～90 mg per time; or tramadol delayed-release tablet, 50～100 mg per time, and propoxyphene tablets and other painkillers can be used. 3.Three-step painkillers: mainly targeting at severe cancer pain, which is difficult for general painkillers to be effective. The representative drugs are morphine tablets or injections, Mescaline (i.e. morphine extended-release tablets), or OxyContin (i.e. oxycodone hydrochloride extended-release tablets); if it can not be taken orally, it can be given through the anus. Fentanyl can also be used. Second, the WHO three-step pain relief principles 1, oral administration. Preferred oral and non-invasive route of administration. Oral medication, non-invasive, convenient, safe and economical. With the progress of research on new dosage forms of painkillers, in addition to oral route of administration, choose other non-invasive route of administration is increasingly widely used, such as transdermal patches for pain relief. If the patient has dysphagia, severe vomiting or gastrointestinal obstruction, transdermal patches, rectal suppositories, etc. can be used. If necessary, continuous subcutaneous infusion using an infusion pump. 2.Giving medicine according to the ladder. This is the cancer pain treatment program recommended by WHO. That is to say, when the pain is mild, use non-opioid drugs and auxiliary drugs; when the pain is moderate, use weak opioid drugs, non-opioid drugs and auxiliary drugs; when the pain is severe, use strong opioid drugs, non-opioid drugs and auxiliary drugs. 3.On time drug administration. It means that painkillers should be given regularly at prescribed intervals. The use of painkillers, you must first determine the dose that can control the patient’s pain, the next dose should be given before the disappearance of the previous dose, so that you can maintain continuous pain relief. Some patients with sudden onset of severe pain, can be given on demand. 4.Individualization of medication. Due to individual differences, there is no ideal standard dosage of opioids, the dosage that can relieve pain is the correct dosage, so the choice of opioids, should start from a small dose, and gradually increase to the ideal dosage for pain relief and no obvious non-response. 5, pay attention to specific details. The use of painkillers should pay attention to the monitoring of patients, closely observe the degree of pain relief, and take the necessary measures in a timely manner, as far as possible to reduce the adverse effects of drugs, improve the effect of pain treatment. Third, the use of drugs need to pay attention to the problem 1, the first appearance of pain, do not panic and lose their heads. People tend to think that once pain occurs, it means the tumor has reached the advanced stage. In fact, there are many reasons causing pain in tumor patients, such as nerve injury after surgery, side effects of some chemotherapy drugs and radiotherapy, etc., all of which may lead to pain. When pain occurs for the first time, patients need to pay attention to the following situations: the time of pain, the degree of pain and the pattern of change. Observe the above situation and tell the doctor about it during the consultation. 2, to the specialist to consult, not to the pain in a hurry to seek medical advice. Only professionally trained doctors can carry out pain treatment, and not any doctor can provide professional advice on pain management. Therefore, it is recommended that patients bring all their medical records to a specialist. If the pain is not well-controlled, there is a possibility that the pain will not be well controlled, but instead many unnecessary side effects will occur, leading to difficulties in future treatment. 3. Give painkillers at the right time. In the past, it was believed that patients with cancer pain should be given pain-relieving treatment only when they are on their deathbed. However, in fact, many cancer patients already have pain at an earlier time, and this pain is often unbearable to the patients. Therefore, for cancer patients with pain, various treatment measures should be taken decisively so that the patient can be relieved of pain both mentally and physically. Pain will make the patient’s general condition deteriorate rapidly, and if it cannot be eliminated in time, it is also very unfavorable to the treatment of cancer. 4.Don’t use Dulcolax. Dulcolax (pethidine) is a synthetic opioid receptor agonist, the pain-relieving effect is only 1/10 of morphine, and the pain-relieving time can only be maintained for 2 to 4 hours. The drug is metabolized in the body to nortriptyline, which has central neurotoxicity and nephrotoxic effects. Cancer patients are bound to cause accumulation and toxicity after high doses of this drug, which can result in tremors, hallucinations, convulsions, muscle spasms and seizures. In addition, the concentration in the blood and subsequently in the brain rises rapidly after injection of Dulcolax, which is easy to produce a sense of euphoria. 5, according to the doctor’s prescription medication. Investigation shows that more than 80% to 90% of cancer pain can be well controlled by drugs. At present, morphine and related drugs are commonly used as effective painkillers. When morphine is mentioned, some patients immediately associate it with drugs and narcotics, and are reluctant to use it for fear of addiction and discomfort after stopping the drug. The doctor’s decision to increase or decrease the medication is based on the patient’s pain level. In the process of medication, patients should not increase or decrease the drug at will, otherwise unexpected consequences may occur. 6, do not worry about “addiction”. Many people worry about the application of opioids will appear “addiction”, in fact, not. Clinical studies have found that opioids, when used in a standardized manner, are generally not “addictive”. The reason is that pain in the body along the neural pathway up the process, generated a special opioid receptors, these receptors “neutralize” the drugs into the body, to avoid due to the activation of opioid receptors in the brain and produce a “floating” feeling; and normal people due to the non-existence of pain The normal people do not have pain stimulation, so after the application of direct stimulation of the brain opioid receptors, leading to “addiction”. Long-term use of drugs and timely treatment of side effects. Most cancer pain lasts for a long time, so treatment is also a long-term process. Therefore, it is important to be patient; otherwise, stopping the medication too soon will not produce actual pain relief. When taking morphine drugs for the first time, some patients may experience side effects such as nausea, vomiting, dizziness and drowsiness, which usually disappear after 3 to 7 days of administration. About 1/3 of the patients will experience constipation. Therefore, patients should drink more water, eat more vegetables, and take the constipation prevention medication prescribed by their doctor. In addition, opioids may inhibit whistling. If you find that the number of whistles is less than 8 per minute, you should pinch the patient immediately to make him feel pain and send him to the hospital in time. 8.Appropriate activities and keep a relaxed mood. Different cancer pain patients have different suitable body movement and daily activities. For example, in breast cancer, one side of arm is swollen and painful after operation, if this side of arm can carry out long-term, appropriate wall climbing and hair combing movements, it is possible to relieve the pain. In addition, patients are too concerned about the disease, which may lead to aggravation of pain. It is recommended that patients distract themselves from the disease by reading books, listening to music, or chatting with family members, etc. Thinking more about happy things and trying to maintain a happy mood will be very helpful for disease recovery as well as pain control.