Use of medical cannabis to reduce pain and improve quality of life in cancer patients.

2015 ◽  
Vol 33 (29_suppl) ◽  
pp. 198-198
Author(s):  
Jessica Cudmore ◽  
Paul Joseph Daeninck
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Retrospective Chart Review ◽  
Clinic Visit ◽  
Average Dose ◽  
Improve Quality ◽  
Medical Cannabis ◽  
Opioid Dose

198 Background: Early attention to pain and symptoms in those with cancer improves both quality of life and survival. Opioid medications are the mainstay treatment of cancer-related pain. Cannabinoids are increasingly used as adjunctive treatments for cancer pain, but clinical evidence supporting their use as an “opioid sparing agent” or to improve quality of life is as yet unknown. Our study sought to determine if the addition of cannabinoids (medical cannabis) resulted in the reduction of the average opioid dose required for pain control, and improve self-reported quality of life indices. Methods: A retrospective chart review of cancer patients followed in our CCMB Pain and Symptom Clinic was conducted. Inclusion criteria: age over 18 years and formal enrollment in Health Canada’s Marihuana for Medical Purposes (MMPR) program (n = 24). Average dose of opioids were calculated in milligrams of morphine equivalent (ME) per day at the last documented visit prior to enrolment in the MMPR and then at the subsequent clinic visit. Averages of self-reported ESAS scores (pain, tiredness, drowsiness, nausea, appetite, depression, anxiety, sense of wellbeing) were calculated for the same visits. Statistical analysis using the paired student’s t-test compared means and determined the significance of any changes. Results: Following enrolment in the MMPR, the average opioid dose decreased by 70.375mg of MEs (p = 0.29). Self-reported ratings (10-point Likert scale) in pain (0.75, p = 0.23), tiredness (0.58, p = 0.21), drowsiness (1.125, p = 0.04), nausea (1.125, p = 0.04), appetite (1.42, p = 0.04), depression (1.29, p = 0.02) and anxiety (1.58, p = 0.004) improved after enrolment. Sense of wellbeing ratings did not change. Conclusions: Patients with cancer pain benefited from the addition of cannabinoids. The average opioid dose decreased following access to medical cannabis. Self-reported ratings of several quality of life indicators showed statistically significant improvement. Our study shows a signal that cannabinoids may reduce cancer patients’ reliance on opioids to control pain. Further prospective controlled studies are needed to further elucidate the role of cannabinoids in the treatment of cancer pain.

scholarly journals A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Intensity Difference ◽  
Front Line ◽  
Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

Amitriptyline in Neuropathic Cancer Pain in Patients on Morphine Therapy: A Randomized Placebo-controlled, Double-blind Crossover Study

2002 ◽  
Vol 88 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Edoardo Arcuri ◽  
Walter Tirelli ◽  
Patrizia Villari ◽  
Alessandra Casuccio
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Double Blind ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

Aims and Background Amitriptyline is the most common analgesic adjuvant used in cancer patients with neuropathic pain, even though no specific studies have demonstrated a benefit. A randomized placebo-controlled, double-blind crossover study was designed to evidence the effects of amitriptyline in patients with neuropathic cancer pain. Methods Sixteen advanced cancer patients with neuropathic pain on systemic morphine therapy, no longer receiving oncologic treatment, presenting moderate pain (about 4 or more, but less than 7, on a numerical scale of 0-10) in the last week, and given a stable morphine dose in the last 2 days were admitted to the study. During the first week of study, patients were administered 25 mg of amitriptyline or equivalent drops of placebo at night for 3 days and 50 mg for the following 4 days. Doses for patients aged more than 65 years were 15 mg (first 3 days) and 30 mg (3 days after). After a week, a crossover took place for the second week, with the other treatment at an inverse sequence. Opioid consumption, pain intensity, symptoms and adverse effects, mood, sleep, patient's preference, quality of life before starting the study, the first week after and the second week after were recorded. Results No significant benefits in analgesia were found in the global pain intensity of the previous week of treatment, the least pain intensity or the pain evaluated just after a week of treatment, at the moment of the visit, when amitriptyline was compared with placebo. A significant difference was evidenced for the worst pain (P < 0.035). No differences in opioid doses during the period of study were found. Drowsiness, confusion and dry mouth were significantly more intense with amitriptyline than with placebo (P < 0.036, 0.003, and 0.034, respectively). There were no substantial differences between the two treatments in Spitzer's quality of life score and for each item. No differences in patients' preference for the two treatment periods were found. The analgesic effects of amitriptyline were slight and associated with adverse effects. Conclusions In light of the results obtained in the study, the extensive use of the drug for cancer pain should be questioned.

Verbessert körperliche Aktivität während der Chemotherapie die Lebensqualität von Krebspatienten?

2015 ◽  
Vol 2 (2) ◽  
pp. 96-97
Keyword(s):  
Quality Of Life ◽  
Physical Activity ◽  
Health Status ◽  
Global Health ◽  
Cancer Patients ◽  
Körperliche Aktivität ◽  
Improve Quality ◽  
European Organisation ◽  
Metabolisches Äquivalent

Hintergrund: Fortschritte in der Krebstherapie haben zur Verlängerung der Überlebenszeit geführt. Dennoch beeinträchtigen Tumorsymptome und Nebenwirkungen immer noch die körperliche Aktivität und Lebensqualität (LQ). Patienten und Methoden: Wir führten eine anonyme Umfrage unter Krebspatienten durch, die sich zu der Zeit einer Chemotherapie unterzogen. Dabei verwendeten wir standardisierte Fragebögen: den Freiburger Fragebogen zur körperlichen Aktivität und den EORTC-Fragebogen QLQ-C30 (EORTC = European Organisation for Research and Treatment of Cancer). Zwei wichtige Fragen wurden untersucht: Gibt es Unterschiede 1) hinsichtlich der körperlichen Aktivität und LQ von Patienten, die nicht glauben, dass Sport ihre LQ verbessern könnte, und solchen, die dies glauben (Gruppe A vs. B), und 2) hinsichtlich der LQ von Patienten mit einer Gesamtaktivität (GA) von <18 MET-h/Woche (MET = metabolisches Äquivalent) und solchen mit einer GA von ≥18 MET-h/Woche (Gruppe C vs. D)? Ergebnisse: 276 von 400 Fragebögen wurden ausgefüllt. Die Gruppen A und B wurden in Bezug auf die Merkmale zu Studienbeginn ausbalanciert. Gruppe A litt signifikant häufiger unter Müdigkeit und Schmerzen; in Gruppe B waren höhere Werte für den allgemeinen Gesundheitsstatus (global health status; GHS) und die GA zu verzeichnen. Die Gruppen C und D unterschieden sich in Geschlechterverteilung, Alter und Bildungsgrad. Gruppe D wies signifikant höhere GHS-Werte auf; Gruppe C litt stärker unter Müdigkeit, Schmerzen und Appetitlosigkeit. Schlussfolgerung: Körperliche Aktivität korreliert bei Krebspatienten unter einer Chemotherapie mit einer höheren LQ. Übersetzung aus Kripp M, et al: Does physical activity improve quality of life in cancer patients undergoing chemotherapy? Oncol Res Treat 2015;38:230-236 (DOI: 10.1159/000381734)

Adult Cancer Pain

2007 ◽  
Vol 5 (8) ◽  
pp. 824
Author(s):  
_ _
Keyword(s):  
Quality Of Life ◽  
Clinical Practice ◽  
Cancer Pain ◽  
National Comprehensive Cancer Network ◽  
Cancer Patients ◽  
Clinical Practice Guidelines ◽  
Practice Guidelines ◽  
Cancer Network ◽  
Recent Version

Pain is one of the most common symptoms associated with cancer and one of the symptoms patients fear most; unrelieved pain denies them comfort and greatly affects their activities, motivation, interactions with family and friends, and overall quality of life. The importance of relieving pain and availability of effective therapies make it imperative that clinicians caring for cancer patients to be adept at assessing and treating cancer pain. The National Comprehensive Cancer Network Adult Cancer Pain Clinical Practice Guidelines in Oncology acknowledge the range of complex decisions faced in caring for these patients. As a result, they provide dosing guidelines for NSAIDs, opioids, and adjuvant analgesics. They also provide specific suggestions for escalating opioid dosage, managing opioid toxicity, and when and how to proceed to other techniques to manage cancer pain. For the most recent version of the guidelines, please visit NCCN.org

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