Pain in cancer patients: Is the increasing of the morphine prescription the best solution?

By Renato Cocchi, MD.

A recent measure of the Italian Minister of Health (prof. Umberto Veronesi, an eminent oncologist) is allowing the physicians an easier use of the morphine in cancer patients, mainly terminal patients.

The prescription is: When there is more pain use more morphine..

This measure seems simplistic and with doubtful rationale for at least two reasons:
1. There is a great physiological serotoninergic antipain mechanism starting from the raphe.
2. An opposite action between opiates and serotonin had got many experimental reports.

This implies two questions:
- Why we cannot first act on serotonin by improving its antipain function?
- Which are the effects of serotonin depression induced by opiates?

Since we are treating terminal patients those two questions might appear mere fussiness, but I suspect that new problems will arise.

Itakian translation


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