scholarly journals Medical Treatment of Cancer Pain: Drug Therapy according to Guidelines Will Improve the Quality of Life of Cancer Patients

2018 ◽  
Vol 93 (3) ◽  
pp. 260-265 ◽  
Author(s):  
Sang-Byung Bae ◽  
Sang-Cheol Lee
Keyword(s):  
Quality Of Life ◽  
Drug Therapy ◽  
Cancer Pain ◽  
Medical Treatment ◽  
Cancer Patients

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.

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

scholarly journals Elimination of pain syndrome in patients with advanced pancreatic head cancer

2019 ◽  
Vol 42 (1) ◽  
pp. 46-52
Author(s):  
T. G. Gevorkyan ◽  
I. A. Feinstein
Keyword(s):  
Quality Of Life ◽  
Pancreatic Cancer ◽  
Drug Therapy ◽  
Cancer Patients ◽  
Clinical Manifestations ◽  
Pancreatic Head ◽  
Pain Syndrome ◽  
Pancreatic Head Cancer ◽  
Surgical Methods

Pain syndrome, along with mechanical jaundice, is one of the most evident clinical manifestations of pancreatic cancer and is often a sign of tumor neglecting. Existing treatment options for chronic pain in cancer patients are diverse and include the various ways of impact on the different links of pathological pain: medicinal, endoscopic, surgical. With this pathology, drug therapy using analgesics, weak and strong opioids, is usually not effective enough. In such cases, preference is given to chemical neurolysis — denervation of the autonomic structures of the retroperitoneal space, carried out under the guidance of ultrasound or computed tomography. Conducting percutaneous neurolysis of the celiac plexus with the use of alcohol or phenol is prescribed upon insufficient effectiveness of pharmacotherapy. Surgical methods of anesthesia are used extremely rarely, as they considerably worsen the patient’s condition, without significantly affecting the quality of life or the prognosis. Thoracoscopic splanchnicectomy is considered a modern and effective method of endoscopic treatment of pain in unresectable pancreatic cancer, the conduction of which can significantly decrease the intensity of pain, reduce the number of narcotic analgesics and improve the quality of life of cancer patients. This minimally invasive intervention is the basis for the subsequent lifelong systemic drug therapy.

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.

The use of oxycodone with naloxone in the cancer patients pain treatment - case reports

Ból ◽  
2017 ◽  
Vol 18 (4) ◽  
pp. 43-46
Author(s):  
Justyna Bochenek-Cibor
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Severe Pain ◽  
Pain Treatment ◽  
Case Reports ◽  
Gastrointestinal Disorders

Cancer pain treatment stays an important part of multidisciplinary oncologic care. Opioids remain the most effective and the most widely used analgesics for the treatment of moderate-to-severe pain. However, they may cause side effects, such as constipation that significantly decrease patients’ quality of life. The combination of oxycodone and naloxone is an innovation in preventing the gastrointestinal disorders. Authors describe two cases of cancer patients for whom oxycodone/naloxe prove effective analgesic.

scholarly journals Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1003
Author(s):  
Arturo Cuomo ◽  
Marco Cascella ◽  
Cira Antonietta Forte ◽  
Sabrina Bimonte ◽  
Gennaro Esposito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Rating Scale ◽  
Assessment System ◽  
P Value ◽  
Breakthrough Cancer Pain ◽  
Pain Clinics ◽  
Eortc Qlq

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS ≤ 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p < 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance.

A survey of cancer patients’ rehabilitation therapy needs in Southwest China.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18003-e18003
Author(s):  
Zhou Jin ◽  
Fang Li ◽  
Peng Xiaodong ◽  
Peng Jingjing ◽  
Jiang Shasha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Medical Treatment ◽  
Cancer Patients ◽  
Mental Stress ◽  
Financial Burden ◽  
Rehabilitation Therapy ◽  
Holistic Treatment ◽  
Cancer Breast ◽  
Medical Advance

e18003 Background: Medical advance in the recent decades has turned cancer into a chronic disease. At the same time, quality of life (LoF) during the treatment period has emerged as a new concern of cancer patients. Rehabilitation therapy, which can help patients conquer fear and be more engaged in the process, has gradually attracted more attentions in China. We designed a survey, for both the cancer patients and their families, to understand their view of the rehabilitation therapy. Methods: We sent paper-based surveys to volunteers consisted of cancer patients and their families. Majority of patients are from 10 cancer centers at the southwest region of China. The main cancer types are lung cancer, breast cancer and colon cancer. The survey questions focus on: patients and their families’ engagement of the treatment, their view on rehabilitation therapy, and their method preference for the rehabilitation therapy. Results: We sent 2,000 copies of the survey and received 1,920 valid inputs. Below are the key findings. 1. Their biggest concern: the outcome of the treatment 55.8%, side effects 19.7%, financial burden 12.8% and mental stress 11.5%. 2. The importance of the rehabilitation therapy as compared to traditional medical treatment, such as surgery and chemotherapy: equally important 67.8%, less important 17.7%, more important 10.1%, no preference 4.4%. 3. The necessity of rehabilitation therapy: very necessary 65.7%, somewhat necessary 22.7%, not necessary 11.6%. 4. The first three reasons for participating rehabilitation therapy: it helped go through the treatment 42.8%, it improved quality of life 31.6% and it helped release their mental stress 22.3%. 5. The best form to conduct rehabilitation therapy: face-to-face communicate with the doctors 60.6%, telecommunication 15.8% and combination of both 22.1%. Conclusions: The results of the survey strongly indicate the demands for rehabilitation therapy. Patients started to understand it – more than half of them think it is as important as the traditional medical treatment. Patients’ quality of life and mental health, which is part of the holistic treatment, are gradually recognized. Next, we plan to group our survey results by types of cancers, patients and their families’ genders and age, as well as the local economics, to better understand the data. We hope this study can serve as a data point to help build China’s rehabilitation therapy infrastructure.

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