This year is the “Year of Pain Removal” as determined by the World Cancer Alliance, and April 12-17 is the 15th National Cancer Prevention and Treatment Awareness Week. According to WHO, 50% of cancer patients receiving treatment have different degrees of pain, 70% of advanced cancer patients have cancer pain as the main symptom, and 30% of cancer patients have unbearable and severe pain. Among cancer patients with different degrees of pain in China, 15%-30% are in the early stage, 40%-55% in the middle stage, and 50%-70% in the late stage. 1/4 of the patients have not received any pain relief treatment, of which 20% are moderately severe. Fifty percent of cancer patients have moderate or high depression, 30% have more severe anxiety, and 59% have thought about suicide. The most important cause of obvious psychological disorders and even suicidal thoughts is the long lasting and unbearable cancer pain. Since the 1980s, the World Health Organization has proposed the “three-step therapy” for cancer pain treatment. In 2001, domestic authoritative experts in oncology, pain and drug dependence discussed and put forward the concept of “standardized pain management” (Good Pain Management) for the first time in China. The standardized pain management is the summary of the development practice of three-step treatment. From stepwise administration to the selection of drugs that can achieve maximum analgesic effect and minimum side effects according to pain intensity, disease type and pathophysiological characteristics of pain, from oral administration to non-invasive administration, from scheduled administration to controlled and slow-release drugs mainly used for cancer pain and chronic pain, from individualized administration to individualized and multi-modal administration, cancer pain and chronic pain treatment has made great progress. According to the current treatment measures, more than 70% of cancer pain patients can have pain relief, but at present, 2/3 of cancer patients worldwide still have moderate or above pain, and 1/4 of them have severe or above pain. This situation is greatly related to the misconceptions of patients and family members about cancer pain treatment. (a) Not to look for oncology specialist and pain specialist Choosing the wrong hospital department for treatment is the first misunderstanding of cancer pain treatment, and it is recommended to choose oncology specialist or pain specialist. Because oncologists, especially pain physicians, have received more education on cancer pain treatment, and most of them have the concept of “three-step treatment principle”. However, non-specialist physicians do not have enough knowledge about cancer pain treatment, which leads to the lack of standardized and effective control of patients’ cancer pain. For example, according to the “three-step approach”, morphine is preferred for chronic pain in severe cancer patients, but non-oncologists are often accustomed to using non-opioid drugs, fearing that “once they are used, they cannot be stopped”. However, non-oncologists are often accustomed to using non-opioid drugs, fearing that they may not be able to stop once they are used. (2) Premature use of opioids can lead to addiction Opioids mainly include aspirin, morphine and other drugs, which are the basic drugs of the “three-step approach”. Many patients and their families, and even health care professionals, are afraid that taking opioids will lead to addiction. This is a very misconception. The chance of addiction is less than 4 in 10,000 if used regularly under the guidance of a physician. That is, for every 10,000 cases of long-term opioid painkiller use, there are less than four addicts. The purpose of opioid use in cancer patients is for pain relief, and when the drug exerts a powerful analgesic effect, its euphoric (addictive) effect takes a back seat. When opioids are used by “normal” people without pain, the blood concentration increases rapidly, resulting in “euphoria” and addiction, which is a kind of mental dependence. Some patients with cancer pain have increased tolerance to opioid painkillers after long-term use, which is a normal pharmacological phenomenon and belongs to physiological dependence, not addiction. (3) Eat only when it hurts, but not when it doesn’t. Also out of fear of opioid painkillers, some patients and family members do not take the medicine according to the rules, but take one when it hurts and not when it doesn’t. This practice will make the pain not be effectively controlled. This practice will not let the pain be effectively controlled. Only when the patient’s condition improves after anti-tumor treatment. Only after the patient’s condition has improved after anti-tumor treatment or the cancer pain has been assessed to be under control, can the medication be stopped. Moreover, discontinuation of medication should be done slowly. Nausea, vomiting and constipation are common adverse effects of opioid painkillers, and some patients have difficulty in tolerating them and stop taking them on their own. The best way is to inform the health care provider and give appropriate treatment, most patients can continue to use the medication. Moreover, most of the health care professionals know that the preventive use of gastrointestinal motility drugs and laxatives can make the patients receive pain relief treatment smoothly. (iv) Long-term use of dulcolax for cancer pain The Guidelines for Clinical Use of Narcotic Drugs clearly emphasize that the use of dulcolax for chronic pain in cancer patients is not recommended. Because the effective action time of dulcolax is very short and the side effects are also great. Take the strong opioid morphine as an example, the pain relief effect of morphine in the body can last for 4-6 hours, while that of dulcolax is only 2-3 hours; the pain relief effect of dulcolax is only 1/8 of that of morphine, but the side effects are large, and after long-term accumulation, the patient may experience tremors, mental confusion, convulsions and other symptoms of central nervous system poisoning. In clinical practice, dulcolax can only be used for short-term acute pain, and is not suitable for chronic pain or cancer pain that requires long-term continuous application of analgesics. Note: The “three-stage therapy” method of medication Mild pain: the first step of NSAIDs is preferred, represented by aspirin; moderate pain: weak opioids, represented by codeine, can be combined with NSAIDs; severe pain: strong opioids, represented by morphine, combined with NSAIDs.