Management of lung cancer-related pain

2011 ◽  
Vol 152 (30) ◽  
pp. 1184-1191 ◽  
Author(s):  
Károly Tagányi

Pain occurs in seventy-four percent of patients suffering from advanced lung cancer, and eighty-two percent of patients feels that the applied treatment of pain was inefficient. The management of cancer-related pain is based on the WHO analgesic ladder. The ladder has three steps. Step one involves the use of nonsteroidal anti-inflammatory drugs for mild pain, step two mild opioids for moderate pain and step three strong opioids for the treatment of heavy pain. This management – in case of emergency – is supplemented by interventional procedures (nerve blockades, surgery). The most effective pain-killing intervention is the all-round oncological and surgical therapy. The different treatments (oncological, radiological, surgical, drug and interventional) are applied in combination with each other. The paper is dealt with the possibility offered by the drug and interventional treatments. Orv. Hetil., 2011, 152, 1184–1191.

2014 ◽  
Vol 32 (16) ◽  
pp. 1677-1690 ◽  
Author(s):  
Janette Vardy ◽  
Meera Agar

The WHO analgesic ladder for the treatment of cancer pain provides a three-step sequential approach for analgesic administration based on pain severity that has global applicability. Nonopioids were recommended for mild pain, with the addition of mild opioids for moderate pain and strong opioids for severe pain. Here, we review the evidence for the use of nonopioid analgesic agents in patients with cancer and describe the mode of action of the main drug classes. Evidence supports the use of anti-inflammatory drugs such as acetaminophen/paracetamol and nonsteroidal anti-inflammatory drugs (NSAIDs) for mild cancer pain. Adding an NSAID to an opioid for stronger cancer pain is efficacious, but the risk of long-term adverse effects has not been quantified. There is limited evidence to support using acetaminophen with stronger opioids. Corticosteroids have a specific role in spinal cord compression and brain metastases, where improved analgesia is a secondary benefit. There is limited evidence for adding corticosteroids to stronger opioids when pain control is the primary objective. Systematic reviews suggest a role for antidepressant and anticonvulsant medications for neuropathic pain, but there are methodologic issues with the available studies. Bisphosphonates improve pain in patients with bony metastases in some tumor types. Denosumab may delay worsening of pain compared with bisphosphonates. Larger studies of longer duration are required to address outstanding questions concerning the use of nonopioid analgesia for stronger cancer pain.


2018 ◽  
Author(s):  
Yutao Liu ◽  
Fang Xu ◽  
Yubo Wang ◽  
Qingchen Wu ◽  
Buhai Wang ◽  
...  

BMC Cancer ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sophie Corriveau ◽  
Gregory R. Pond ◽  
Grace H. Tang ◽  
John R. Goffin

Abstract Background Chronic obstructive pulmonary disease (COPD) and lung cancer are associated diseases. COPD is underdiagnosed and thus undertreated, but there is limited data on COPD diagnosis in the setting of lung cancer. We assessed the diagnosis of COPD with lung cancer in a large public healthcare system. Methods Anonymous administrative data was acquired from ICES, which links demographics, hospital records, physician billing, and cancer registry data in Ontario, Canada. Individuals age 35 or older with COPD were identified through a validated, ICES-derived cohort and spirometry use was derived from physician billings. Statistical comparisons were made using Wilcoxon rank sum, Cochran-Armitage, and chi-square tests. Results From 2002 to 2014, 756,786 individuals were diagnosed with COPD, with a 2014 prevalence of 9.3%. Of these, 51.9% never underwent spirometry. During the same period, 105,304 individuals were diagnosed with lung cancer, among whom COPD was previously diagnosed in 34.9%. Having COPD prior to lung cancer was associated with lower income, a rural dwelling, a lower Charlson morbidity score, and less frequent stage IV disease (48 vs 54%, p < 0.001). Spirometry was more commonly undertaken in early stage disease (90.6% in stage I-II vs. 54.4% in stage III-IV). Conclusion Over a third of individuals with lung cancer had a prior diagnosis of COPD. Among individuals with advanced lung cancer, greater use of spirometry and diagnosis of COPD may help to mitigate respiratory symptoms.


Author(s):  
Jana B. Adizie ◽  
Judith Tweedie ◽  
Aamir Khakwani ◽  
Emily Peach ◽  
Richard Hubbard ◽  
...  

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