DEVELOPMENTS IN THE TREATMENT OF CANCER PAIN IN FINLAND - THE 3RD NATIONWIDE SURVEY

This survey was designed to investigate the current status of the mana gement of cancer pain in Finland. In 1995 a questionnaire was randomly sent to 5% (n = 546) of Finnish physicians, excluding specialists not expected to treat cancer patients. Two previous surveys, using the sa me questionnaire, were conducted in 1985 and 1990 by Vainio. The respo nse rate was 53%. Seventy-nine percent of the respondents treated one or less than one cancer patient a week. Sixty-seven percent of them as sessed the severity of cancer pain in their patients as being at least moderate. In 10 years, the proportion of physicians suggesting the WH O analgesic ladder principle to their 'typical cancer patient' had inc reased from 12% to 28%. At the same time, the suggestions of 'analgesi c' without definition had decreased from 48% to 6%. Three simulated pa tient cases were presented. The mean daily dose of opioids suggested f or severe terminal cancer pain corresponded to 72 (18-300) mg of intra muscular morphine in 1995, being only 39 (1-77) mg in 1985 for the sam e simulated patient case. Continuous infusion of opioid was recommende d by 59% of the respondents. Non-steroidal anti-inflammatory drugs as the treatment of choice for bone metastases pain in a patient with bre ast cancer, was recommended by 63% of the respondents. In the case of local severe pain due to recurrent rectal cancer, 68% of the physician s suggested anaesthetic intervention. Insufficient pain relief and lac k of experience were the most common difficulties in pain management. Only one-third of the physicians thought that they had enough time and ability to give sufficient psychological support to their patients. ( C) 1997 International Association for the Study of Pain.