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Abstract
Cancer pain is a serious health problem, and imposes a great burden on the lives of patients and their families. Pain can be associated with delay in treatment, denial of treatment, or failure of treatment. If the pain is not treated properly it may impair the quality of life. Neuropathic cancer pain (NCP) is one of the most complex phenomena among cancer pain syndromes. NCP may result from direct damage to nerves due to acute diagnostic/therapeutic interventions. Chronic NCP is the result of treatment complications or malignancy itself. Although the reason for pain is different in NCP and noncancer neuropathic pain, the pathophysiologic mechanisms are similar. Data regarding neuropathic pain are primarily obtained from neuropathic pain studies. Evidence pertaining to NCP is limited. NCP due to chemotherapeutic toxicity is a major problem for physicians. In the past two decades, there have been efforts to standardize NCP treatment in order to provide better medical service. Opioids are the mainstay of cancer pain treatment; however, a new group of therapeutics called coanalgesic drugs has been introduced to pain treatment. These coanalgesics include gabapentinoids (gabapentin, pregabalin), antidepressants (tricyclic antidepressants, duloxetine, and venlafaxine), corticosteroids, bisphosphonates, N-methyl-D-aspartate antagonists, and cannabinoids. Pain can be encountered throughout every step of cancer treatment, and thus all practicing oncologists must be capable of assessing pain, know the possible underlying pathophysiology, and manage it appropriately. The purpose of this review is to discuss neuropathic pain and NCP in detail, the relevance of this topic, clinical features, possible pathology, and treatments of NCP.
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Affiliation(s)
- Ece Esin
- Medical Oncology Department, Hacettepe University Cancer Institute, Ankara, Turkey
| | - Suayib Yalcin
- Medical Oncology Department, Hacettepe University Cancer Institute, Ankara, Turkey
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Leung JG, Nelson S, Leloux M. Pharmacotherapy During the End of Life: Caring for the Actively Dying Patient. AACN Adv Crit Care 2014. [DOI: 10.4037/nci.0000000000000010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Affiliation(s)
- Jonathan G. Leung
- Jonathan G. Leung is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 . Sarah Nelson is Critical Care Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Megan Leloux is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota
| | - Sarah Nelson
- Jonathan G. Leung is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 . Sarah Nelson is Critical Care Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Megan Leloux is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota
| | - Megan Leloux
- Jonathan G. Leung is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, 200 1st St SW, Rochester, MN 55905 . Sarah Nelson is Critical Care Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota. Megan Leloux is Psychiatric Clinical Pharmacy Specialist, Hospital Pharmacy Services, Mayo Clinic, Rochester, Minnesota
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Sun Y, Guan Z, Liao M, Yu X, Wang C, Wang J, Niu X, Shi Y, Zhi X, Liu Y, Liu M, Zhang Y, Yang Y, Shen J, Chen G, Zhou Q, Zhou C, Guo Q, Tang L, Duan J, Liang J, Zhang Y, Cheng Y. [Expert consensus on the diagnosis and treatment of bone metastasis in lung cancer (2014 version)]. ZHONGGUO FEI AI ZA ZHI = CHINESE JOURNAL OF LUNG CANCER 2014; 17:57-72. [PMID: 24581154 PMCID: PMC6000054 DOI: 10.3779/j.issn.1009-3419.2014.02.01] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- Yan Sun
- Cancer Hospital, Chinese Aacademy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Zhongzhen Guan
- SunYat-Sen University Cancer Center,Guangzhou 510060, China
| | - Meilin Liao
- Shanghai Chest Hospital, Shanghai, 200030, China
| | - Xin Yu
- Department of psychiatry, Peking University Sixth Hospital, Beijing 100191, China
| | - Changli Wang
- Department of Lung Cancer Surgery, Tianjin Cancer Hospital, Tianjin 300060, China
| | - Jie Wang
- Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Peking University, Beijing 100142, China
| | - Xiaohui Niu
- Department of Orthopedic Oncology Surgery, Beijing Jishuitan Hospital, Beijing 100035, China
| | - Yuankai Shi
- Department of Medical Oncology, Cancer Hospital, Chinese Aacademy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
| | - Xiuyi Zhi
- Department of Thoracic Surgery, Beijing Lung Cancer Center, Beijing Xuanwu Hospital, Capital Medical University, Beijing 100053, China
| | - Yunpeng Liu
- Departmentof Medical Oncology, the First Hospital of China Medical University, Shenyang 110001, China
| | - Mengzhong Liu
- Department of Radiotherapy, Sun Yat-Sen University Cancer Center, Guangzhou 510060, China
| | - Yiping Zhang
- Department of Chemotherapy, Zhejiang Cancer Hospital, Hangzhou 310022, China
| | - Yue Yang
- Department of Thoracic Surgery, Beijing Cancer Hospital, Peking University, Beijing 100142, China
| | - Jingnan Shen
- Department of Orthopedic Oncology Surgery, the First Affiliated Hospital Sun Yat-Sen University, Guangzhou 510080, China
| | - Gongyan Chen
- Department of Medical Oncology, Haerbin Medical University Cancer Hospital, Haerbin 150081, China
| | - Qinghua Zhou
- Department of Thoracic Surgery, Tianjin Medical University General Hospital, Tianjin 300052, China
| | - Caicun Zhou
- Departmentof Medical Oncology, Shanghai Pulmonary Hospital, Shanghai 200433, China
| | - Qisen Guo
- Department of Medical Oncology, Shandong Province cancer Hospital, Jinan 250117, China
| | - Lili Tang
- Department of rehabilitation, Beijing Cancer Hospital, Peking University, Beijing 100142, China
| | - Jianchun Duan
- Department of Thoracic Medical Oncology, Beijing Cancer Hospital, Peking University, Beijing 100142, China
| | - Jun Liang
- Department of Medical Oncology, the Affiated Hospital of Qingdao University, Qingdao 266003, China
| | - Yingjian Zhang
- Department of Nuclear Medicine, Fudan University Shanghai Cancer Center, Shanghai 200032, China
| | - Ying Cheng
- Department of Medical Oncology, Jilin Cancer Hospital, Changchun 130012, China
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Auret K, Schug SA. Pain management for the cancer patient - current practice and future developments. Best Pract Res Clin Anaesthesiol 2013; 27:545-61. [PMID: 24267557 DOI: 10.1016/j.bpa.2013.10.007] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2013] [Accepted: 10/07/2013] [Indexed: 01/16/2023]
Abstract
Anaesthesiologists will be asked to provide pain management for cancer patients in the absence of more specialised services, when interventional techniques are indicated and in the postoperative period. In all these settings, the complexity of cancer pain and its psychosocial connotations need to be considered to provide appropriate and holistic care. Principles of systemic pain management, effective in most patients, continue to follow established guidelines; identification of neuropathic pain and its appropriate treatment is important here. Interventional pain relief is required in a minority of cancer patients, but it should be considered when appropriate and then done with best available expertise. Neurolytic procedures have lost importance here over the years. Postoperative pain management should be multimodal with consideration of regional techniques when applicable. In managing postoperative pain in cancer patients, opioid tolerance needs to be addressed to avoid withdrawal and poor analgesia. Preventive techniques aiming to reduce chronic postoperative pain should be considered.
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Affiliation(s)
- Kirsten Auret
- Rural Clinical School of WA, UWA Science Building M701, 35 Stirling Tce, Albany, WA 6330, Australia.
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Ripamonti CI, Santini D, Maranzano E, Berti M, Roila F. Management of cancer pain: ESMO Clinical Practice Guidelines. Ann Oncol 2013; 23 Suppl 7:vii139-54. [PMID: 22997447 DOI: 10.1093/annonc/mds233] [Citation(s) in RCA: 266] [Impact Index Per Article: 24.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Affiliation(s)
- C I Ripamonti
- Supportive Care in Cancer Unit, Fondazione IRCCS, Istituto Nazionale Tumori, Milan, Italy
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