23. Pain in Patients with Cancer.

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Bibliographic Details
Title: 23. Pain in Patients with Cancer.
Authors: Vissers, Kris C. P., Besse, Kees, Wagemans, Michel, Zuurmond, Wouter, Giezeman, Maurice J.M.M., Lataster, Arno, Mekhail, Nagy, Burton, Allen W., van Kleef, Maarten, Huygen, Frank
Source: Pain Practice. Sep/Oct2011, Vol. 11 Issue 5, p453-475. 23p. 1 Color Photograph, 1 Black and White Photograph, 1 Diagram, 8 Charts.
Subjects: Denervation, Diagnosis of abdominal pain, Treatment of abdominal pain, Cancer pain treatment, Catheterization, Nerve block, Analgesics, Backache, Cancer pain, Catheters, Drug delivery systems, Drug infusion pumps, Infusion therapy, Spinal injections, Health outcome assessment, Pancreatic tumors, Pelvic tumors, Epidural anesthesia, Physical diagnosis, Stomach tumors, Surgical complications, Terminal care, Evidence-based medicine, Treatment effectiveness, Compression fractures, Symptoms, Diagnosis
Abstract: Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate application of these interventional techniques provides better pain control, allows the reduction of analgesics and hence improves quality of life. Until recently, the majority of these techniques are considered to be a fourth consecutive step following the World Health Organization's pain treatment ladder. However, in cancer patients, earlier application of interventional pain management techniques can be recommended even before considering the use of strong opioids. Epidural and intrathecal medication administration allow the reduction of the daily oral or transdermal opioid dose, while maintaining or even improving the pain relief and reducing the side effects. Cervical cordotomy may be considered for patients suffering with unilateral pain at the level below the dermatome C5. This technique should only be applied in patients with a life expectancy of less than 1 year. Plexus coeliacus block or nervus splanchnicus block are recommended for the management of upper abdominal pain due to cancer. Pelvic pain due to cancer can be managed with plexus hypogastricus block and the saddle or lower end block may be a last resort for patients suffering with perineal pain. Back pain due to vertebral compression fractures with or without pathological tumor invasion may be managed with percutaneous vertebroplasty or kyphoplasty. All these interventional techniques should be a part of multidisciplinary patient program. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
Description
Abstract:Pain in patients with cancer can be refractory to pharmacological treatment or intolerable side effects of pharmacological treatment may seriously disturb patients' quality of life. Specific interventional pain management techniques can be an effective alternative for those patients. The appropriate application of these interventional techniques provides better pain control, allows the reduction of analgesics and hence improves quality of life. Until recently, the majority of these techniques are considered to be a fourth consecutive step following the World Health Organization's pain treatment ladder. However, in cancer patients, earlier application of interventional pain management techniques can be recommended even before considering the use of strong opioids. Epidural and intrathecal medication administration allow the reduction of the daily oral or transdermal opioid dose, while maintaining or even improving the pain relief and reducing the side effects. Cervical cordotomy may be considered for patients suffering with unilateral pain at the level below the dermatome C5. This technique should only be applied in patients with a life expectancy of less than 1 year. Plexus coeliacus block or nervus splanchnicus block are recommended for the management of upper abdominal pain due to cancer. Pelvic pain due to cancer can be managed with plexus hypogastricus block and the saddle or lower end block may be a last resort for patients suffering with perineal pain. Back pain due to vertebral compression fractures with or without pathological tumor invasion may be managed with percutaneous vertebroplasty or kyphoplasty. All these interventional techniques should be a part of multidisciplinary patient program. [ABSTRACT FROM AUTHOR]
ISSN:15307085
DOI:10.1111/j.1533-2500.2011.00473.x