A questionnaire survey was carried out with the aim of evaluating know
ledge about and practice of cancer pain treatment in Denmark. A questi
onnaire was sent out to a 10% random sample of Danish physicians. Of t
hese 1411 physicians, 1068 (76%) returned the questionnaires and after
exclusion of those doctors who never treated cancer patients, 577 (54
%) were analyzed. Their knowledge of the principles and pratice of can
cer pain treatment was evaluated by means of 14 multiple-choice and op
en questions. Their ability to apply their knowledge in practice was e
valuated by analyzing their suggested treatment of 3 simulated patient
cases. The results show that a vast majority (97%) of the physicians
were prepared to use opioids conventionally administered for severe pa
in and that 39% reported the use of other treatment modalities (psycho
logical treatment, antineoplastic therapy, transcutaneous nerve stimul
ation/acupuncture, etc.). Ninety-seven percent of the physicians recog
nized difficulties in cancer pain treatment, the most frequent being s
ide effects of drugs and inadequate pain relief. Seventy-five percent
considered that their knowledge about pain treatment was fair or bette
r. The overall evaluation of the proposals for pain treatment of the p
atient cases was primarily based on drug therapy. Adequate doses, corr
ect dose intervals and selection of drugs, routes of administration an
d other treatments were the requirements for satisfactory answers. It
appears that the majority the physicians could treat both pain from bo
ne metastasis (75%) and visceral pain (78%) satisfactorily, while very
few suggested co-analgesics for neuropatic pain conditions (20%). Old
er physicians performed less well than their younger colleagues. Basic
pain treatment skills have been acquired by the Danish physicians but
, in the future, emphasis should be placed on the treatment of neuropa
thic pain with co-analgesics and the management of opioid side effects
.