Cancer pain Research Papers - Academia.edu (original) (raw)

The purpose of this randomized controlled study was to investigate the effect of a pain education program (PEP) on pain intensity,... more

The purpose of this randomized controlled study was to investigate the effect of a pain education program (PEP) on pain intensity, patients' satisfaction with pain treatment, and patient-related barriers to pain management among Turkish patients with cancer. The study was conducted in a sample of 40 patients who were hospitalized for cancer and experiencing pain. The patients were equally randomized to either a PEP or a control group. The data were collected by means of the McGill Pain Questionnaire, the Numeric Rating Scale, and the Barrier Questionnaire-Revised. After the completion of the questionnaires at the first interview, patients in the PEP group received pain education using a pain educational booklet and an explanatory slide program that discussed the booklet's content with the patients. Patients in the control group received routine clinical care. The questionnaires were reapplied to the patients in both groups after 2, 4, and 8 weeks. Participation in a PEP was associated with decreased pain intensity scores for "present" and "least pain" during weeks 2, 4, and 8 (p < .05). Similarly, there were significant differences between the groups with respect to weeks 2, 4, and 8 satisfaction with pain treatment (p < .05). At the end of second week, the total BQ-r score decreased significantly in the PEP group from 2.12 to 1.29 compared with 2.30 to 2.28 in the control group (p < .001). The findings suggest that the PEP decreases pain intensity, improves satisfaction with treatment, and decreases barriers about cancer pain management in cancer patients. Incorparation of PEP into the standard of care for cancer patients with pain may improve the quality of pain management.

In the oncology community, opioids recently have become the cornerstone of cancer pain management. This has led to a rapid increase in opioid prescribing in an effort to address the growing public health problem of chronic pain. A new... more

In the oncology community, opioids recently have become the cornerstone of cancer pain management. This has led to a rapid increase in opioid prescribing in an effort to address the growing public health problem of chronic pain. A new paradigm in noncancer pain management has emerged, that of risk assessment and stratification in opioid therapy. Techniques foreign to cancer pain management have now become commonplace in the noncancer pain setting, such as the use of monitoring compliance via urine drug screens. Amidst these strides in opioid use for pain management, cancer has been changing. The survival rate has increased, and a group of these patients with chronic pain were treated with opioid therapy. With opioid exposure being longer and against the backdrop of prescription drug abuse, the question is how much of the adaptation of the risk management paradigm in chronic pain management is to be imported to cancer pain management?

A case of: 60 yr, male with Chondrosarcoma-Grade II of the Ilium, operated with recurrence of tumor and was a known case of hypertension, Diabetes Mellitus under treatment along with h/o PTCA, stricture urethra attended the pain clinic... more

A case of: 60 yr, male with Chondrosarcoma-Grade II of the Ilium, operated with recurrence of tumor and was a known case of hypertension, Diabetes Mellitus under treatment along with h/o PTCA, stricture urethra attended the pain clinic with severe intractable unilateral right lower extremity pain.
His pain was treated sucessfully with unilateral lumbar subarachnoid alcohol neurolytic block. The VAS of 10/10 could be reduced to 2/10 postprocedure - We have used smaller volume (0.3ml) to get good sensory block of L-4 without any motor block

Several interventional radiology procedures are available for the management of cancer pain. In this article, we will briefly review the different procedures and their value in the setting of cancer pain management under two main... more

Several interventional radiology procedures are available for the management of cancer pain. In this article, we will briefly review the different procedures and their value in the setting of cancer pain management under two main categories: indirect action (regional anesthesia from neurolysis) and direct action on the tumor. Percutaneous ablation of bone tumors: alcohol, laser, radiofrequency, microwaves, ultrasound, and cryoablation. Several indications have previously been validated, including thermal ablation of bone metastases with results superior to conventional therapies. Additional applications should be validated over the next few years.

Effective pain management requires accurate knowledge, attitudes, and assessment skills. The purpose of the present study was to examine information about the knowledge and attitudes of Turkish oncology nurses regarding cancer pain... more

Effective pain management requires accurate knowledge, attitudes, and assessment skills. The purpose of the present study was to examine information about the knowledge and attitudes of Turkish oncology nurses regarding cancer pain management. The sample consisted of 68 oncology nurses employed in oncology and hematology units in two university hospitals located in Izmir, Turkey. The Nurses' Knowledge and Attitudes Survey Regarding Pain was used to measure the nurses' pain management knowledge and attitudes. Data were analyzed by using descriptive statistics, t test, Kruskal-Wallis analysis, and Pearson correlation test. Of the nurses that participated in the study, 57.4% were between the ages of 21 and 30 years, 58.8% were unmarried, and 55.9% had an associate degree. The average correct response rate was 35.41%, with rates ranging from 5.13% to 56.41% for each survey question. Among the 39 pain knowledge questions assessed, the mean number of correctly answered questions was 13.81 +/- 5.02, with a range of 2 to 22 items correctly answered. When the knowledge scores were further analyzed by nurses' background characteristics, the nurses' pain knowledge was only positively correlated to length of working experience in oncology units (r = 0.263; p < .05). The findings support the concern of inadequate knowledge and attitudes in relation to cancer pain management. We believe that basic and continuing education programs may improve knowledge level of nursing about pain management.

Sedation and tiredness are among the most frequent symptoms among cancer patients. A detailed assessment of these symptoms is necessary to evaluate therapeutic effects, such as the use of methylphenidate or comparison of different... more

Sedation and tiredness are among the most frequent symptoms among cancer patients. A detailed assessment of these symptoms is necessary to evaluate therapeutic effects, such as the use of methylphenidate or comparison of different opioids. The Brief Fatigue Inventory (BFI) has been validated as a short and comprehensive instrument to assess severity of fatigue and fatigue-related impairment in cancer patients. We validated the German version of the BFI in patients with chronic cancer-related and noncancer-related pain treated in a tertiary pain center. Patients treated in the Pain Clinic of the Department of Anesthesiology completed the BFI, the minimal documentation system (MIDOS) and the short form SF-36 quality-of-life questionnaire (SF-36). Test-retest reliability was assessed with a second BFI immediately after the consultation and in a subgroup of patients after 3 to 7 days. Nineteen percent of the 117 patients were treated for cancer-related pain (C); the other patients suffe...

Opioid abuse has increased at an alarming rate. However, available evidence suggests a wide variance in the use of opioids, as documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement... more

Opioid abuse has increased at an alarming rate. However, available evidence suggests a wide variance in the use of opioids, as documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement Administration (DEA). The objective of these opioid guidelines by the American Society of Interventional Pain Physicians (ASIPP) is to provide guidance for the use of opioids for the treatment of chronic non-cancer pain, to bring consistency in opioid philosophy among the many diverse groups involved, to improve the treatment of chronic non-cancer pain, and to reduce the incidence of drug diversion. A policy committee evaluated a systematic review of the available literature regarding opioid use in managing chronic non-cancer pain. This resulted in the formulation of the essentials of guidelines, a series of potential evidence linkages representing conclusions, followed by statements regarding relationships between clinical interventions and outcomes. Consi...

PENGARUH TERAPI MUSIK DENGAN MASALAH NYERI TERHADAP PASIEN KANKER ABSTRAK Kanker merupakan salah satu penyakit atau kelainan pada tubuh sebagai akibat dari sel-sel tubuh yang tumbuh dan berkembang abnormal diluar batas kewajaran. Kanker... more

Opioid abuse has continued to increase at an alarming rate since our last opioid guidelines were published in 2005. Available evidence suggests a continued wide variance in the use of opioids, as documented by different medical... more

Opioid abuse has continued to increase at an alarming rate since our last opioid guidelines were published in 2005. Available evidence suggests a continued wide variance in the use of opioids, as documented by different medical specialties, medical boards, advocacy groups, and the Drug Enforcement Administration. The objectives of opioid guidelines by the American Society of Interventional Pain Physicians (ASIPP) are to provide guidance for the use of opioids for the treatment of chronic non-cancer pain, to bring consistency in opioid philosophy among the many diverse groups involved, to improve the treatment of chronic non-cancer pain, and to reduce the incidence of abuse and drug diversion. A broadly based policy committee of recognized experts in the field evaluated the available literature regarding opioid use in managing chronic non-cancer pain. This resulted in the formulation of the review and update of the guidelines published in 2006, a series of potential evidence linkages...

Cancer pain, caused by the disease itself or its treatments, is common. This session discussed pain management strategies that nurses can share with patients experiencing pain. The program covered variables that must be considered when... more

Cancer pain, caused by the disease itself or its treatments, is common. This session discussed pain management strategies that nurses can share with patients experiencing pain. The program covered variables that must be considered when selecting an initial opioid for managing pain, the concept of opioid rotation for patients experiencing severe pain, neuropathy assessment and treatment, and the future of cancer pain management.

Breast cancer is one of the most prevalent cancers amongst women in the world. Unfortunately, even after adequate treatment, some patients experience severe pain either due to disease progression or due to treatment related side effects.... more

Breast cancer is one of the most prevalent cancers amongst women in the world. Unfortunately, even after adequate treatment, some patients experience severe pain either due to disease progression or due to treatment related side effects. The persistent pain causes a negative physical and psychosocial impact on patients’ lives. Current rational pain management is patient-centred and requires a thorough psychological assessment. Usually adequate analgesia is achieved by adopting the WHO’s three step analgesic ladder. As the disease progresses, the pain experienced by the patient also increases. This necessitates the administration of opioids and adjuvant analgesics to the breast cancer patients experiencing severe pain. However, opioid use is associated with intolerable side effects like constipation, nausea, vomiting, fear of dependence, and tolerance. Concomitant medications are required to combat these unacceptable side effects. Adjuvant analgesics need to be added to provide adequate and satisfactory analgesia. These factors worsen the psychological state of patients and deteriorate their quality of life. Hence, there is a need to develop therapeutic modalities to provide adequate analgesia with minimum side effects. This review article focuses on the current treatments available for cancer pain management, their limitations, and novel targets and non-pharmacological measures under investigation which have the potential to produce a radical change in pain management measures for the breast cancer patients.

Opioid analgesics are frequently used for the long-term management of chronic pain states, including cancer pain. The prolonged use of opioids is associated with a requirement for increasing doses to manage pain at a consistent level,... more

Opioid analgesics are frequently used for the long-term management of chronic pain states, including cancer pain. The prolonged use of opioids is associated with a requirement for increasing doses to manage pain at a consistent level, reflecting the phenomenon of analgesic tolerance. It is now becoming clearer that patients receiving long-term opioid therapy can develop unexpected abnormal pain. Such paradoxical opioid-induced pain, as well as tolerance to the antinociceptive actions of opioids, has been reliably measured in animals during the period of continuous opioid delivery. Several recent studies have demonstrated that such pain may be secondary to neuroplastic changes that result, in part, from an activation of descending pain facilitation mechanisms arising from the rostral ventromedial medulla (RVM). One mechanism which may mediate such pain facilitation is through the increased activity of CCK in the RVM. Secondary consequences from descending facilitation may be produced...

For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in... more

For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in such facilities are on opioids. Opioids can be considered broad-spectrum analgesics that act at multiple points along the pain pathway. Unfortunately, opioids also have the potential for great harm, with multiple side effects and potential complications, some of which are lethal. They are also uniquely addictive, which can lead to misuse and diversion. We reviewed the relevant English literature and did thorough manual searches of the bibliographies of known primary and review articles. We utilized pain relief as the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, improvement in work status, and evidence of addiction. Short-term use and improvement was defined as less than 6 months and l...

For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in... more

For thousands of years, opioids have been used to treat pain, and they continue to be one of the most commonly prescribed medications for pain. It is estimated that 90% of patients presenting to pain centers and receiving treatment in such facilities are on opioids. Opioids can be considered broad-spectrum analgesics that act at multiple points along the pain pathway. Unfortunately, opioids also have the potential for great harm, with multiple side effects and potential complications, some of which are lethal. They are also uniquely addictive, which can lead to misuse and diversion. We reviewed the relevant English literature and did thorough manual searches of the bibliographies of known primary and review articles. We utilized pain relief as the primary outcome measure. Other outcome measures were functional improvement, improvement of psychological status, improvement in work status, and evidence of addiction. Short-term use and improvement was defined as less than 6 months and l...

The management of chronic pain remains a challenge because of its complexity and unpredictable response to pharmacological treatment. In addition, accurate pain management may be hindered by the prejudice of physicians and patients that... more

The management of chronic pain remains a challenge because of its complexity and unpredictable response to pharmacological treatment. In addition, accurate pain management may be hindered by the prejudice of physicians and patients that strong opioids, classified as step 3 medications in the World Health Organization ladder for cancer pain management, are reserved for the end stage of life. Recent information indicates the potential value of strong opioids in the treatment of chronic nonmalignant pain. There are, up until now, insufficient data to provide indications about which opioid to use to initiate treatment or the dose to be used for any specific pain syndrome. The strong inter-patient variability in opioid receptor response and in the pharmacokinetic and pharmacodynamic behavior of strong opioids justifies an individual selection of the appropriate opioid and stepwise dose titration. Clinical experience shows that switching from one opioid to another may optimize pain contro...

Pain and other symptoms of advanced cancer are not treated effectively yet. This review of the literature discusses the needs and latest research findings about pain symptom assessment and management in palliative care. Pain assessment... more

Pain and other symptoms of advanced cancer are not treated effectively yet. This review of the literature discusses the needs and latest research findings about pain symptom assessment and management in palliative care. Pain assessment scores should not be followed blindly by a rigid therapeutic regimen. Instead, the health care provider should carefully consider the wide spectrum of possible underlying pain mechanisms. Unidimensional pain rating scales will not detect the impact of affective dimensions on pain expression as accurately as multidimensional rating scales that include various symptoms. Besides assessment tools like numeric rating scales or visual analogue scales, tools now frequently used in the daily clinical setting include the Edmonton Symptom Assessment System, the Mini Mental State Examination, and the CAGE questionnaire (Cutting down, Annoyance by criticism, Guilty feeling, and Eye-openers). Recent developments and findings in cancer pain management are illustrat...