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duncani infections are more widespread globally than presently recognized.The increased recognition of the high prevalence and important burden of cancer pain and the documentation of a large proportion of patients receiving inadequate analgesic treatment should have reinforced the need for evidence-based recommendations. The World health Organization (WHO) guidelines on cancer pain management-or palliative care-are traditionally based on a sequential, three-step, analgesic ladder according to pain intensity nonopioids (paracetamol or n