scholarly journals PROBLEM OF CHRONIC PAIN IN ONCOLOGY AND APPROACHES TO ITS RELIEF

2020 ◽  
Vol 1 (1) ◽  
pp. 32-42
Author(s):  
T. P. Protasova ◽  
A. S. Goncharova ◽  
G. V. Zhukova ◽  
E. A. Lukbanova ◽  
S. Yu. Tkachev ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Cancer Progression ◽  
Pain Syndrome ◽  
Patient Specific ◽  
Physical Factors ◽  
Nonspecific Effects ◽  
Acceptable Quality ◽  
Pathogenetic Therapy ◽  
Endocrine Status

This article reviews modern ideas about the pathogenesis of chronic pain in cancer patients and describes main approaches to its relief. Special attention is focused on factors important for the development of a patient-specific approach to the pathophysiology and management of chronic pain syndrome. These factors include genetics, gender, age, early anamnesis, patients’ immunological and endocrine status, as well as those shedding light on the pathogenetic aspects of chronic pain thus facilitating the choice of an optimal therapeutic approach. The review identifies limitations of pharmacotherapy as the major method of chronic pain management and justifies the need for alternative approaches. The latter include monitoring of the circadian rhythms of pain and various nonspecific effects, such as physical factors, psychological methods or reflex therapy. The experience and possibilities of non–pharmacological methods in the complex pathogenetic therapy of chronic pain are analysed, along with preventive measures permitting the development of chronic pain to be avoided. The pathological disorganizing and stressful role of chronic pain is considered with regard to the theory of functional systems. The pathogenetic significance of chronic pain in carcinogenesis and cancer progression is illustrated by examples from scientific literature. The authors emphasize the necessity of effective pain prevention, including invasive methods, in order to ensure an acceptable quality of life for cancer patients at any stage of the malignant process.

scholarly journals COMORBIDITY OF NON-PSYCHOTIC MENTAL DISORDERS AND NEUROLOGIC SYMPTOMS AMONG YOUNG PEOPLE

2020 ◽  
Vol 73 (8) ◽  
pp. 1605-1609
Author(s):  
Valeriy М. Pashkovskyy ◽  
Оlha S. Yurtsenyuk
Keyword(s):  
Chronic Pain ◽  
Young People ◽  
Mental Disorders ◽  
Somatoform Disorders ◽  
Pain Syndrome ◽  
Behavioral Syndromes ◽  
Clear Correlation ◽  
Physical Factors ◽  
Chronic Pain Syndrome ◽  
And Behavior

The aim: to determine occurrence and structure of non-psychotic mental disorders associated with chronic pain among young people. Materials and methods: The results of examination of 1235 students were analyzed. The following methods were applied: clinical, clinical-psychopathological, clinicalepidemiological, clinical-anamnestic, experimental-psychological and statistical. Results: Students with neurotic disorders associated with stress and somatoform disorders were found to prevail in the main group (F40-48.1) 187 (58,99%), affective mood disorders were on the second position (F30-34.1) - 79 (24,92%) individuals, followed by disorders of a mature personality and behavior of adults (F60-60.7) diagnosed in 31 (9,78%) students, and at last, behavioral syndromes associated with physiological disorders and physical factors (F50-51.4) - 20 (6,30%) respectively. Chronic pain syndrome was diagnosed in 113 (35,65%) students with NMD including 43 (38,05%) men and 70 (61,95%) women. The majority of young people (86 individuals – 76,11%) observed severe pain, and 27 (23,89%) of them – moderate pain. A clear correlation was found between a depressive episode and CPS (γ<0,02). Conclusions: The findings obtained should be considered in development of screening systems concerning diagnostics, prevention of nonpsychotic mental disorders associated with chronic pain syndrome.

scholarly journals Stress and its molecular consequences in cancer progression

2017 ◽  
Vol 71 (1) ◽  
pp. 0-0 ◽  
Author(s):  
Magdalena Surman ◽  
Marcelina E. Janik
Keyword(s):  
Cancer Patients ◽  
Cancer Progression ◽  
Hormone Receptors ◽  
Emotional Experience ◽  
Stress Hormones ◽  
Stress Factors ◽  
Physical Factors ◽  
Anti Cancer ◽  
And Migration

Stress, caused by psychological, physiological and physical factors has an adverse impact on human body homeostasis. There are two kind of stress: short-term and chronic. Cancer patients usually live under chronic stress, caused by diagnosis-related strong emotional experience and depression, resulting from various difficulties associated with disease progression and treatment. At the molecular level, stress factors induce production and secretion of stress-related hormones, such as catecholamines, glucocorticoids and dopamine (as a part of adaptational body response), which influence both normal and transformed cells through their specific receptors. The particular effects exerted by these molecules on cancer cells have been also observed in in vitro cultures and include changes in proliferation, apoptosis susceptibility and migration/invasion potential. As a result, it has been suggested that stress hormones may be responsible for progression of malignancy and thus accelerate the metastasis formation in cancer patients. However, the clinical data on correlation between stress and the patients survival, as well as the molecular analysis of stress hormone receptors expression and action in cancer cell, have not yet provided an unequivocal answer. For this reason, extensive studies, on molecular and clinical level are needed to fully determine stress impact on cancerprogression and on the effectiveness of anti-cancer treatment. Nowadays, it seems reasonable that the personalization of anti-cancer therapy should also focus on mental state of cancer patients, and provide them with psychological tools or techniques for stress management.

scholarly journals Indicators of the psychoemotional state of palliative polymorbid cancer patients

2021 ◽  
Vol 20 (2) ◽  
pp. 69-74
Author(s):  
U. V. Kharlamova ◽  
О. V. Kurchenkova ◽  
A. О. Abdalov ◽  
К. A. Shubina ◽  
S. I. Samodurov
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Psychoemotional State ◽  
Personal Anxiety ◽  
Comorbidity Index ◽  
High Level ◽  
The Impact ◽  
Palliative Patients

Introduction. Palliative care is aimed at maintaining and improving the quality of life of the patient. Without taking into account the psychosocial aspects, psychological rehabilitation is impossible in the conditions of a psychotraumatic situation of the disease.The aim of the study was to assess the psychoemotional state of polymorbid palliative cancer patients.Materials and methods. An observational, analytical, single-stage (cross-sectional) study was conducted, which included 74 cancer patients of a palliative profile. The patients underwent laboratory and instrumental examination. The following tests were evaluated: resilience (S. Maddy's method, D. A. Leontiev's adaptation), life-sense orientations, the level of subjective control, C. D. Spielberger, the severity of chronic pain syndrome; the value of the Charlson comorbidity index, the Karnovsky index (ECOG) was calculated.Results. The level of the comorbidity index was 3 [2; 5] points, the intensity of chronic pain syndrome-2 [2; 3] points, ECOG-2 [2; 3] points. In polymorbid cancer palliative patients, the presence of a belief in the impact of the struggle on the outcome of what is happening was revealed, however, patients are not always ready to act in a difficult situation. In the examined group, signs of dissatisfaction with their life in the present prevailed, the lack of sufficient freedom of choice, the existence of hope for recovery as a result of the actions of others, primarily doctors. The average (and in some cases high) level of situational and personal anxiety was noted. The association of the comorbidity index and the indicators of the life-meaning orientations test; the indicator of the general internality scale and the ECOG value; the glomerular filtration rate and the indicator of resilience, risk acceptance was revealed. A number of correlations between the indicators of the psychoemotional state and laboratory parameters (the level of hemoglobin, albumin, iron, C-reactive protein) were noted.Conclusion. In cancer patients with a palliative profile, signs of mental maladaptation were revealed. The average (and in some cases high) level of situational and personal anxiety was noted. The revealed number of correlations focuses on the role of chronic non-communicable diseases in aggravating the psychoemotional status of chronic polymorbid cancer palliative patients.

scholarly journals Chronic pain syndromes: overlapping phenotypes with common mechanisms

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 255 ◽  
Author(s):  
Geoffrey Owen Littlejohn ◽  
Emma Guymer
Keyword(s):  
Chronic Pain ◽  
Complex Regional Pain Syndrome ◽  
Emotional Distress ◽  
Pain Syndrome ◽  
Physical Factors ◽  
Pain Syndromes ◽  
The Common ◽  
Chronic Pain Syndromes

The common chronic pain syndromes of fibromyalgia, regional pain syndrome, and complex regional pain syndrome have been made to appear separate because they have been historically described by different groups and with different criteria, but they are really phenotypically accented expressions of the same processes triggered by emotional distress and filtered or modified by genetics, psychology, and local physical factors.

scholarly journals EFFICACY AND SAFETY OF MORPHINE HYDROCHLORIDE IN CANCER PATIENTS WITH CHRONIC PAIN

2019 ◽  
Vol 18 (4) ◽  
pp. 27-33
Author(s):  
R. A. Zukov ◽  
O. P. Bobrova ◽  
G. N. Gildeeva ◽  
D. V. Butuzova ◽  
E. A. Ershova
Keyword(s):  
Chronic Pain ◽  
Adverse Effects ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Efficacy And Safety ◽  
Strong Intensity ◽  
Group I ◽  
Significant Difference ◽  
Morphine Hydrochloride

Purpose of the study: to assess the efficacy and safety of morphine hydrochloride in the form of 10 mg filmcoated tablets and 1 % solution for injection in cancer patients with chronic pain syndrome of strong intensity.Material and Methods. The study included 110 cancer patients with chronic pain syndrome of strong intensity. The study was conducted in compliance with the principles of the Helsinki Declaration, ICH GCP, GOST R 52379-2005, as well as other Russian laws regulating the conduct of clinical trials and work with opioid analgesics. Patients were randomized at a 1:1 ratio. Group I received 10 mg film-coated morphine tablets, 1 tablet orally every 4 hours for 7 days. Group II received 1 % morphine solution for injection, intramuscularly, 4 mg every 4 hours for 7 days. A Numeric Rating Scale for Pain (NRS, 0–100 mm) was used to assess the level of pain. The safety assessment was based on the collection of data on the registration of adverse events, including opioid-associated adverse effects.Results. Enteral and parenteral morphine administration for 7 days demonstrated a statistically significant decrease in the intensity of pain syndrome in cancer patients. The use of morphine hydrochloride in tablets reduced the number of additional analgesics prescribed for cancer patients. Regarding opioid-associated adverse effects, a statistically significant difference in the incidence of constipation between two groups was observed.Conclusion. The study showed that tablets and injectable dosage forms of morphine hydrochloride were comparable in efficacy and safety profile, thus predetermining the widespread clinical use of drugs produced by the domestic manufacturer in accordance with the “pain relief ladder”, proposed by WHO. 

scholarly journals The Study of Pharmacokinetics Parameters of Morphine Hydrochloride, Long-acting Tablets in Cancer Patients with Severe Chronic Pain Syndrome

2020 ◽  
Vol 9 (2) ◽  
pp. 119-123
Author(s):  
E. A. Ezhova ◽  
I. G. Kotelnikova ◽  
A. V. Teteneva ◽  
D. V. Butuzova ◽  
K. F. Tetenev
Keyword(s):  
Chronic Pain ◽  
Cancer Patients ◽  
Maximum Concentration ◽  
Study Drug ◽  
Pain Syndrome ◽  
Pharmacokinetic Parameters ◽  
Chronic Pain Syndrome ◽  
Coated Tablet ◽  
Long Acting ◽  
Morphine Hydrochloride

Introduction. Effective drug therapy for cancer patients with chronic pain syndrome (CPS) of high intensity is one of the priorities of modern healthcare. Currently, non-narcotic and narcotic analgesics are used for pain relief according to a three-steps scheme. In the absence of contraindications, it is preferable to prescribe medications per os and prolonged forms, which will allow the patient to maintain selfcare and comfort.Aim. To study the pharmacokinetic properties of a drug with a prolonged mechanism of action «Morphine hydrochloride», in a film-coated tablet formof a dosage 30 mg, in cancer patients with severe CPS.Materials and methods. For the analysis of the pharmacokinetics of the studied drug after single and multiple doses of 20 patients who received 10- day analgesic therapy with the studied drug «Morphine hydrochloride», long-acting film-coated 30 mgtablets. manufacturer FSUE Moscow Endocrine Plant, Russia. Route of administration: per os. The study duration was 17 days: screening duration up to 7 days; duration of therapy up to 10 days.Results and discussion. The concentration of morphine in plasma was determined by HPLC-tandem mass spectrometry, within 12 hours after taking the study drug (1 of long-acting, film-coated tablet 30 mg). The following pharmacokinetic parameters were obtained on Day 5: T1/2 – 6.08 ± 4.37 hours and 14.46 ± 30.86 hours, Tmax – 2.5 ± 1.86 hours, Cmax – 43.91 ± 27.24 ng/ml. Values of pharmacokinetic parameters averaged over all days are presented. It was found that T1/2 for the studied drug T1/2 is 9.21 ± 14.94 hours, Tmax 2.87 ± 2.36 hours. The average maximum concentration (Cmax) on the day of the study drug was 36.52 ng/ml.Conclusion. As a result of the study of pharmacokinetics, it was found that the drug «Morphine hydrochloride», long-acting tablets film-coated with a of 30 mg was found in serum after oral administration after 15 minutes and reaches a maximum concentration in the blood in 3 hours, the half-life is on average 9 hours, the maximum concentration is 36.52 ng/ml.

scholarly journals Genetic Polymorphism of Cytokines as a Predictor of Phenotypic Development of Chronic Pain Syndrome in Cancer Patients

2017 ◽  
Vol 7 (4) ◽  
pp. 277-281
Author(s):  
Olga Bobrova ◽  
◽  
Natalia Shnayder ◽  
Marina Petrova ◽  
Oksana Gavrilyuk ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Genetic Polymorphism ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Chronic Pain Syndrome ◽  
Phenotypic Development

Analysis of the assortment of narcotic drugs used for the treatment of pain in cancer patients in the palliative care unit

2021 ◽  
Vol 2 (88) ◽  
pp. 93-96
Author(s):  
N. V. Orlova ◽  
◽  
N.V. Abrosimova ◽  
Yu.A. Melnitskaya ◽  
I.V. Kryukova ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Palliative Care ◽  
Cancer Patients ◽  
Pain Syndrome ◽  
Opioid Analgesics ◽  
Dosage Forms ◽  
Palliative Care Unit ◽  
Chronic Pain Syndrome ◽  
Oncological Center ◽  
Narcotic Drugs

A study of the assortment of narcotic drugs for the relief of acute and chronic pain syndrome in cancer patients in the palliative care unit of the Oncological Center was carried out. It has been shown that practically all registered dosage forms of opioid analgesics are used

scholarly journals Are there any gender differences in pain perception? Clinical and experimental studies in oncology

2021 ◽  
Vol 67 (6) ◽  
pp. 755-760
Author(s):  
Elena Frantsiyants ◽  
Inga Kotieva ◽  
Elena Sheiko ◽  
Iurii Sidorenko
Keyword(s):  
Gender Differences ◽  
Chronic Pain ◽  
Cancer Patients ◽  
Pain Perception ◽  
Experimental Studies ◽  
Pain Syndrome ◽  
Living Organism ◽  
The Body ◽  
Protective Function ◽  
Mechanisms Of Development

The review considers and analyzes scientific literature on gender differences in the incidence of pain syndromes, perception of clinical pain, including that in cancer patients and in experimental oncology. The literature highlights theoretical basis, some biological mechanisms and practical results associated with gender differences. Chronic pain no longer performs a protective function and is not biologically appropriate. The review presents results of experimental studies demonstrating the important role of sex hormones and regulatory systems of a living organism in the mechanisms of development, distribution and perception of pain. Some aspects of sexual dimorphism in the processes of nociception and antinociception are covered. We present the data on the causes of chronic pain syndrome and its perception in cancer patients of both sexes indicating genetically determined sexual reactivity of the body which causes an imbalance in the function of peripheral nervous system and CNS under the influence of prolonged permanent pain in a living organism. Various pain effects have been shown to cause changes in the main types of metabolism, mobilization of adaptive metabolic mechanisms, and tissue damage. Conclusions. The high prevalence of chronic pain in both women and men with cancer, heavy humanitarian and social and economic burden explains a significant increase in fundamental and clinical research in this direction.      

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