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Cancer pain management

C Roger Goucke, Pongparadee Chaudakshetrin
Approximately 80% of the world's population lives in countries with little or no access to pain management. These countries also have 74% of the world's deaths from cancer and human immunodeficiency virus. Appropriate use of oral opioids can control 80%-90% of cancer pain. However, only 6.7% of the world's medical opioids are available in these low-resource countries. With the Lancet Commission on Global Surgery calling for a significant expansion of surgical services, postoperative pain management will need to be an increasing focus of our attention...
April 2018: Anesthesia and Analgesia
Young Dong Yu, Jin Ho Hwang, Young Eun Seo, Byung Do Song, Yeon Soo Jung, Dong Hwan Lee, Sung Kyu Hong, Seok-Soo Byun, Sang Eun Lee, Jong Jin Oh
This study aimed to evaluate the effects of ketorolac, a commonly used non-steroidal anti-inflammatory drug (NSAID) as patient controlled intravenous infusion analgesia (PCIA) for the patients underwent radical cystectomy (RC) due to bladder cancer regarding post-operational indices of recovery. Total seventy patients who underwent radical cystectomy for the treatment of bladder cancer were included in the study. 35 patients received ketorolac as PCIA (NSAIDS group) and 35 patients had morphine infusion as PCIA (morphine group)...
March 15, 2018: Scientific Reports
Amin A Ramzan, Stacy Fischer, Mary K Buss, Renata R Urban, Bruce Patsner, Linda R Duska, Christine M Fisher, Carolyn Lefkowits
As the only oncologists that provide both medical and surgical care, gynecologic oncologists encounter an exceptionally broad range of indications for prescribing opioids in clinical situations ranging from management of acute post-operative pain to chronic cancer-related pain to end-of-life care. While opioids are essential to the practice of gynecologic oncology, they can also have significant side effects and can be misused. Due to the explosive growth of opioid prescriptions and opioid-related overdoses and deaths during the first decade of the 21st century, there has been a recent concerted public health effort to prevent and treat opioid misuse through both legislation and education [1]...
March 12, 2018: Gynecologic Oncology
Marie Fallon, Jane Walker, Lesley Colvin, Aryelly Rodriguez, Gordon Murray, Michael Sharpe
Purpose Pain is suboptimally managed in patients with cancer. We aimed to compare the effect of a policy of adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and management Tool [EPAT]) to usual care (UC) versus UC alone on pain outcomes. Patients and Methods In a two-arm, parallel group, cluster randomized (1:1) trial, we observed pain outcomes in 19 cancer centers in the United Kingdom and then randomly assigned the centers to either implement EPAT or to continue UC...
March 15, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
Scott A Mosley, J Kevin Hicks, Diane G Portman, Kristine A Donovan, Priya Gopalan, Jessica Schmit, Jason Starr, Natalie Silver, Yan Gong, Taimour Langaee, Mike Clare-Salzler, Petr Starostik, Young D Chang, Sahana Rajasekhara, Joshua E Smith, Heloisa P Soares, Thomas J George, Howard L McLeod, Larisa H Cavallari
INTRODUCTION: Pain is one of the most burdensome symptoms associated with cancer and its treatment, and opioids are the cornerstone of pain management. Opioid therapy is empirically selected, and patients often require adjustments in therapy to effectively alleviate pain or ameliorate adverse drug effects that interfere with quality of life. There are data suggesting CYP2D6 genotype may contribute to inter-patient variability in response to opioids through its effects on opioid metabolism...
March 10, 2018: Contemporary Clinical Trials
Anas Nooh, Krista Goulding, Marc H Isler, Sophie Mottard, Annie Arteau, Norbert Dion, Robert Turcotte
BACKGROUND: Bone metastases represent the most frequent cause of cancer-related pain, affecting health-related quality of life and creating a substantial burden on the healthcare system. Although most bony metastatic lesions can be managed nonoperatively, surgical management can help patients reduce severe pain, avoid impending fracture, and stabilize pathologic fractures. Studies have demonstrated functional improvement postoperatively as early as 6 weeks, but little data exist on the temporal progress of these improvements or on the changes in quality of life over time as a result of surgical intervention...
March 2018: Clinical Orthopaedics and related Research
Michelle L Dossett, Gloria Y Yeh
Homeopathy is used by just over 2% of the U.S. population, predominantly for respiratory, otorhinolaryngology, and musculoskeletal complaints. Individual users who see a homeopathic provider for care are more likely to perceive the therapy as helpful than those who do not; however, only 19% of users in the United States see a provider. The rest presumably rely upon over-the-counter products. Recent clinical trials highlight several areas in which homeopathy may play a role in improving public health, including infectious diseases, pain management, mental health, and cancer care...
February 2018: Homeopathy: the Journal of the Faculty of Homeopathy
Jun Arimoto, Takuma Higurashi, Shingo Kato, Akiko Fuyuki, Hidenori Ohkubo, Takashi Nonaka, Yoshikazu Yamaguchi, Keiichi Ashikari, Hideyuki Chiba, Shungo Goto, Masataka Taguri, Takashi Sakaguchi, Kazuhiro Atsukawa, Atsushi Nakajima
Background and study aims:  Colorectal cancer (CRC) is one of the most common neoplasms and endoscopic submucosal dissection (ESD) is an effective treatment for early-stage CRC. However, it has been observed that patients undergoing ESD often complain of pain, even if ESD has been successfully performed. Risk factors for such pain still remain unknown. The aim of this study was to explore the risk factors for post-colorectal ESD coagulation syndrome (PECS). Patients and methods : This was a prospective multicenter observational trial (UMIN000016781) conducted in 106 of 223 patients who underwent ESD between March 2015 and April 2016...
March 2018: Endoscopy International Open
Joseph Arthur, Kimberson Tanco, Minjeong Park, Ali Haider, Courtney Maligi, Shalini Dalal, Syed M A Naqvi, Diane Liu, Eduardo Bruera
BACKGROUND: There is currently no universally accepted outcome measure in cancer pain management. The personalized pain goal (PPG) has been shown to be a relevant outcome measure. We examined its use in routine outpatient practice and compared it with the clinical important difference (CID, ≥2 points or 30%), a pain outcome measure frequently used in several clinical studies. METHODS: Initial and follow up clinical information of outpatients with advanced cancer pain were retrospectively reviewed...
March 8, 2018: Journal of Pain and Symptom Management
Harpreet Singh, Amanda J Walker, Laleh Amiri-Kordestani, Joyce Cheng, Shenghui Tang, Pamela Balcazar, Kimberly Barnett-Ringgold, Todd R Palmby, Xianhua Cao, Nan Zheng, Qi Liu, Jingyu Yu, William F Pierce, Selena R Daniels, Rajeshwari Sridhara, Amna Ibrahim, Paul G Kluetz, Gideon M Blumenthal, Julia A Beaver, Richard Pazdur
On July 17, 2017, the Food and Drug Administration (FDA) approved neratinib (NERLYNX, Puma Biotechnology, Inc) for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab-based therapy. Approval was based on data from ExteNET, a randomized, double-blind, placebo-controlled multicenter trial. Women with early-stage HER2-positive breast cancer and within two years of completing adjuvant trastuzumab were randomized to neratinib (n=1420) or placebo (n=1420) for one year...
March 9, 2018: Clinical Cancer Research: An Official Journal of the American Association for Cancer Research
Tarik Mahfoud, Rachid Tanz, Mohamed Réda Khmamouche, Mohamed Allaoui, Rhizlane Belbaraka, Mouna Khouchani, Mohamed Ichou
Synchronous primary cancers involving the pancreas and kidney are extremely rare and poorly documented. We report the first case of this association treated with chemotherapy and tyrosine kinase inhibitor. A 70-year-old woman presented with a 2-month history of epigastric pain with weight loss of 12 kg. Two weeks previously, she had presented with jaundice and pelvic pain. A computed tomography (CT) scan of the body revealed the presence of an irregular mass in the body of the pancreas, encasing the celiac trunk, with dilatation of the biliary tract...
September 2017: Case Reports in Oncology
Masood Umer, Yasir Mohib, Muhammed Atif, Muhammad Nazim
Background: Renal cell carcinoma account for 3% of all cancers, with peak incidence between 60 and 70 years of age predominantly affecting male population. Renal carcinoma is the most common malignancy of kidney constitutes for 80-90% of renal neoplasm with an overall 45% five years survival rate. Majority are diagnosed incidentally during investigation for other disease process of abdomen. Classical triad of gross hematuria, pain and palpable mass in abdomen is rare accounting to only 6-10%...
March 2018: Annals of Medicine and Surgery
Qiang Liu, Lu-Lu Gao, Ya-Liang Dai, Yu Wang, Hai-Xia Wang, Xiang-Jiang Luo, Xiao-Min Chai, Guo-Xia Mu, Xiao-Yan Liang, Xi Zhang, Juan Liu, Jian-Qiang Yu, Yu-Xiang Li
Breakthrough pain is an extremely painful symptom that impairs quality of life in cancer patients. It negatively impacts their emotional wellbeing, physical function, and mental health. The aim of this study is to use a qualitative methodology to examine the perception of cancer patients with breakthrough pain in the Northwest of China. A semi-structured, face-to-face interview was conducted with nine cancer patients who experienced breakthrough pain; and a qualitative content analysis was performed. Five themes were generated: (1) sufferings from breakthrough cancer pain, (2) hopelessness and helplessness, (3) perception of breakthrough cancer pain and analgesia, (4) strong as a Chinese, and (5) support needed from health care system...
March 2, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Ly Thuy Nguyen, Kimberly Alexander, Patsy Yates
OBJECTIVES: To assess the feasibility of conducting a trial of a psycho-educational intervention involving the provision of tailored information and coaching to improve management of a cancer-related symptom cluster (fatigue, pain and sleep disturbance) and reduce symptom cluster impacts on patient health outcomes in the Vietnamese context, and to undertake a preliminary evaluation of the intervention. METHODS: A parallel-group single blind pilot quasi-experimental trial was conducted with 102 cancer patients in one Vietnamese hospital...
March 2, 2018: Journal of Pain and Symptom Management
Robert Knoerl, Zach Chornoby, Ellen M L Smith
Patients undergoing treatment for cancer commonly experience symptoms such as sleep disturbance, pain, anxiety, depression, and low energy/fatigue (SPADE), subsequently altering physical function and complicating effective symptom management. However, little is known about the frequency, severity, and clustering of SPADE symptoms in individuals with chronic painful chemotherapy-induced peripheral neuropathy (CIPN). The purpose of this cross-sectional, secondary analysis was to describe the frequency, severity, and clustering of SPADE symptoms and their association with physical function in individuals with chronic painful CIPN...
March 1, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Lisa M Blackburn, Stephanie Abel, Lori Green, Kristen Johnson, Shannon Panda
Pain is one of the most feared of all symptoms for the cancer patient. Some studies estimate that up to 90% of all cancer patients experience pain. Advances in pharmaceuticals and expert provider knowledge have improved pain management overall for the patient with cancer; however, complementary therapies can synergize medications to provide optimal pain relief while decreasing the side effect profile. Despite this, nurses may have limited access to such resources. Many therapies can be administered directly by the bedside/chairside nurse with minimal training and the nurse can then teach the patient and family how to use the selected complementary therapy after leaving the hospital or clinic...
February 28, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Ernest Barthélemy, Joshua Loewenstern, Neeraja Konuthula, Margaret Pain, Jordan Hall, Satish Govindaraj, Joshua Bederson, Raj K Shrivastava
PURPOSE: The initial management of atypical meningiomas poses a distinct clinical challenge in that treatment protocols have not been fully established, and outcomes, especially differences by patient age, have not been broadly measured. The National Cancer Database (NCDB) allows for analysis of a large, diverse patient population to determine clinical parameters and survival outcomes based on the initial treatment of patients with atypical meningiomas. METHODS: Analysis of the NCDB yielded 3611 atypical meningioma patients treated between 2008 and 2012...
March 2, 2018: Journal of Cancer Research and Clinical Oncology
Judith A Paice
Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions. Unfortunately, access to these therapies has been hampered by interventions designed to contain another serious public health problem: the opioid misuse epidemic. This epidemic and the unintended consequences of efforts to control this outbreak are leading to significant barriers to the provision of cancer pain relief...
March 2, 2018: Cancer
Yu-Lin Lin, Ruey Kuen Hsieh, Chao-Hsiun Tang
AIM: Pain assessment and management have been important criteria in hospital accreditation in Taiwan since 2007. We used a Taiwanese health insurance database to determine factors influencing patterns of strong opioid use in cancer patients in their final 12 months of life. METHODS: Data from patients with cancer in Taiwan outpatient clinics with cancer-related deaths between 2008 and 2011 were included in the analysis. Strong opioid prescription data from the last 12 months of each patient's life, as well as patient, physician, and hospital characteristics, were collected from the National Health Insurance Research Database...
March 2, 2018: Asia-Pacific Journal of Clinical Oncology
Joe Jabbour, James Wykes, Chris Milross, Puma Sundaresan, Ardalan Ebrahimi, Heather L Shepherd, Haryana M Dhillon, Jonathan R Clark
BACKGROUND: Providing appropriate educational resources to patients with head and neck cancer (HNC) is important but challenging. The aim of this study was to determine Australian clinicians' perceptions of currently used HNC information resources. METHODS: A purpose-designed questionnaire was disseminated electronically to clinician members of the Australian and New Zealand Head and Neck Cancer Society (ANZHNCS) and The Australian Society of Otolaryngology Head and Neck Surgery (ASOHNS)...
March 2, 2018: Asia-Pacific Journal of Clinical Oncology
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