• Title/Summary/Keyword: Cancer Pain Management

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The nature of triple-negative breast cancer classification and antitumoral strategies

  • Kim, Songmi;Kim, Dong Hee;Lee, Wooseok;Lee, Yong-Moon;Choi, Song-Yi;Han, Kyudong
    • Genomics & Informatics
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    • v.18 no.4
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    • pp.35.1-35.7
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    • 2020
  • Identifying the patterns of gene expression in breast cancers is essential to understanding their pathophysiology and developing anticancer drugs. Breast cancer is a heterogeneous disease with different subtypes determined by distinct biological features. Luminal breast cancer is characterized by a relatively high expression of estrogen receptor (ER) and progesterone receptor (PR) genes, which are expressed in breast luminal cells. In ~25% of invasive breast cancers, human epidermal growth factor receptor 2 (HER2) is overexpressed; these cancers are categorized as the HER2 type. Triple-negative breast cancer (TNBC), in which the cancer cells do not express ER/PR or HER2, shows highly aggressive clinical outcomes. TNBC can be further classified into specific subtypes according to genomic mutations and cancer immunogenicity. Herein, we discuss the brief history of TNBC classification and its implications for promising treatments.

Stereotaxic Neurotomy of the Ganglion Impar in the Management of Perineal Pain -A case report- (회음부통증 환자를 위한 Ganglion Impar의 정위적 신경절제술 -증례 보고-)

  • Shin, Keun-Man;Kim, Jin-Soo;Cho, Yong-Roew;Lim, So-Young;Hong, Soon-Yong;Choi, Young-Ryong
    • The Korean Journal of Pain
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    • v.9 no.2
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    • pp.415-418
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    • 1996
  • The first reported the neural blockade of ganglion impar for pain control of perineal pain in 1990 by Plancarte and his fellows. they used 6ml of 10 percent phenol. but the point of issues, same as other neurolytics, are that it is impossible to check and control its spreading, so it might be possible to destruct the coccygeal plexus and sacral nerve, and also it has only short action time. Because of these problems, it could be very dangerous to attempt this procedure especially not for relieving the pain on cancer terminal patient, but for the sympathectomy of ganglion impar on the other purpose. We used the RF generator which had the control ability to point out the destructive lesion accurately. inserted We made the small burr hole on the sacrum near the sacrococcygeal junction directly, through the hole, and performed thermocoagulation to the ganglion impar.

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Post-traumatic Back Pain Revealed as Tuberculous Spondylitis -A Case Report-

  • Kim, Bum-Suk;Shin, Jeong-Hee;Moon, Ho-Sik;Chon, Jin-Young;Sung, Choon-Ho
    • The Korean Journal of Pain
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    • v.23 no.1
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    • pp.74-77
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    • 2010
  • Tuberculous spondylitis is a very rare disease, but it can result in bone destruction, kyphotic deformity, spinal instability, and neurologic complications unless early diagnosis and proper management are done. Because the most common symptom of tuberculous spondylitis is back pain, it can often be misdiagnosed. Atypical tuberculous spondylitis can be presented as a metastatic cancer or a primary vertebral tumor. We must make a differential diagnosis through adequate biopsy. A 30-year-old man visited our clinic due to back and chest pain after a recent traffic accident. About 1 year ago, he had successfully recovered from tuberculous pleurisy after taking anti-tuberculosis medication. We performed epidural and intercostal blocks but the pain was not relieved. For the further evaluation, several imaging and laboratory tests were done. Finally, we confirmed tuberculous spondylitis diagnosis with the biopsy results.

The Use of Caudal Epidural Steroid for the Management of Intractable Coccygodynia (불인성 미골통에 Caudal Epidural Steriod 이용 -증례보고-)

  • Ahn, Myung-Ja;Suh, Jae-Hyun;Kim, Sung-Nyeun
    • The Korean Journal of Pain
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    • v.5 no.1
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    • pp.89-91
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    • 1992
  • Coccygodynia is a pain syndrome resulting from trauma, fractures, infection and tumor, and is usually amenable to conservative treatment. We present one case of coccygodynia that developed 2 days after percutaneous cordotomy done for pain control of cervix cancer unresponsive to conservative treatment which subsequently was treated with a caudal injection of lidocaine and triamcinolone. Caudal epidural steroid injection is less invasive and has less potential for complication than the neurosurgical interruption of the pain pathway.

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SKF96365 impedes spinal glutamatergic transmission-mediated neuropathic allodynia

  • Qiru Wang;Yang Zhang;Qiong Du;Xinjie Zhao;Wei Wang;Qing Zhai;Ming Xiang
    • The Korean Journal of Physiology and Pharmacology
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    • v.27 no.1
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    • pp.39-48
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    • 2023
  • Spinal nerve injury causes mechanical allodynia and structural imbalance of neurotransmission, which were typically associated with calcium overload. Storeoperated calcium entry (SOCE) is considered crucial elements-mediating intracellular calcium homeostasis, ion channel activity, and synaptic plasticity. However, the underlying mechanism of SOCE in mediating neuronal transmitter release and synaptic transmission remains ambiguous in neuropathic pain. Neuropathic rats were operated by spinal nerve ligations. Neurotransmissions were assessed by whole-cell recording in substantia gelatinosa. Immunofluorescence staining of STIM1 with neuronal and glial biomarkers in the spinal dorsal horn. The endoplasmic reticulum stress level was estimated from qRT-PCR. Intrathecal injection of SOCE antagonist SKF96365 dose-dependently alleviated mechanical allodynia in ipsilateral hind paws of neuropathic rats with ED50 of 18 ㎍. Immunofluorescence staining demonstrated that STIM1 was specifically and significantly expressed in neurons but not astrocytes and microglia in the spinal dorsal horn. Bath application of SKF96365 inhibited enhanced miniature excitatory postsynaptic currents in a dosage-dependent manner without affecting miniature inhibitory postsynaptic currents. Mal-adaption of SOCE was commonly related to endoplasmic reticulum (ER) stress in the central nervous system. SKF96365 markedly suppressed ER stress levels by alleviating mRNA expression of C/ EBP homologous protein and heat shock protein 70 in neuropathic rats. Our findings suggested that nerve injury might promote SOCE-mediated calcium levels, resulting in long-term imbalance of spinal synaptic transmission and behavioral sensitization, SKF96365 produces antinociception by alleviating glutamatergic transmission and ER stress. This work demonstrated the involvement of SOCE in neuropathic pain, implying that SOCE might be a potential target for pain management.

Nurse's Role Performance and Perception of the Importance of Role among Nurses Practicing in a Cancer Care Facility (암 전문병원 간호사의 간호역할 수행도와 중요도)

  • Chae, Young Hee;Lee, Won Hee;Min, Young Mi;Shin, A Mi;Kim, Hyang Mi
    • Journal of Korean Clinical Nursing Research
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    • v.19 no.3
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    • pp.407-418
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    • 2013
  • Purpose: The purpose of this study is to examine the nurse's role performance and the perception of the importance of role among nurses practicing in a cancer care facility. Methods: A descriptive study design was applied with convenient sampling of 175 nurses working at a cancer care facility in Daegu, Korea. Data was collected using a structured questionnaire from July 1, 2013 to July 5, 2013. Results: Cancer care facility nurse's role performance score was measured on average $3.23{\pm}0.64.$ Oral medication was the most frequently performed role, followed by encouragement, care related to medication, and pain management. The perception of the importance of nurse's role was measured on average $3.31{\pm}0.35$. Care related to medication was regarded as the most important, followed by transfusion, oral medication, and intravenous & intramuscular medication. Nurse's role performance was different according to nurse's age (F=3.21, p=.024) and current practice area (F=3.73, p=.012). The perception of the importance of nurse's role was different only in relation to current practice area (F=6.82, p<.001). Conclusion: Nurses practicing in oncology setting frequently involve encouraging patients and pain management. Training programs designed to facilitate frequently performed and highly regarded nurse's roles are required for nurses practicing in oncology setting.

Pilot Study on Development of Telecommunication Guideline for Symptom Management of Lung Cancer Patients (폐암환자 증상관리를 위한 전화상담 가이드라인 개발 예비 조사)

  • Sung, Ji-Hyun;Kim, Min-Young;Hwang, Ok-Hee;Yoo, Han-Jin;Lee, Eun-Ja
    • Asian Oncology Nursing
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    • v.10 no.2
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    • pp.218-230
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    • 2010
  • Purpose: This study was conducted to develop the telecommunication guideline that was possible to make the immediate, logical decisions and to evaluate the possibility of the use by verifying it from the specialists' group. Methods: Telecommunication guideline was designed with selected six symptoms which were pain, dyspnea, nausea/vomiting, diarrhea, fever, and cough based on the results of literature. Results: This study showed that the patients understood well about the contents of the questions, examination, and education. Also, 85% of them fulfilled the guidelines of the adjustment and more of them were satisfied with the results shown to all of them compared to the previous telecommunication. And 95% of them replied that the information from the telecommunication was more useful than any other information sources related to the information of cancer and self management that were used previously. Conclusion: The telecommunication was considered to complement the weakness during the time the cancer patients spent at home after the treatments. Also, it was expected to be a role as an immediate and comprehensive method of decision making and a passage for information supply which was considered the specialty of individual patient related to an inquiry of the self management.

Knowledge and Attitudes toward Palliative Terminal Cancer Care among Thai Generalists

  • Budkaew, Jiratha;Chumworathayi, Bandit
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.10
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    • pp.6173-6180
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    • 2013
  • Background: Our objective was to determine the knowledge and attitudes of Thai generalists (general physicians) toward palliative terminal cancer care (PC) in a primary care setting. Materials and Methods: We performed a cross-sectional descriptive survey using a self-administered questionnaire. The total number of completed and returned questionnaires was 63, giving a 56% response rate. Data analysis was based on these (Cronbach's alpha=0.82) and percentages and mean values were assessed using the Fisher's exact test to determine the correlation of variables. Results: Overall, attitude and knowledge levels were slightly satisfactory. Results indicated that general physicians had moderate scores in both attitudes (84.1%) and knowledge (55.7%) regarding palliative terminal cancer care. However, they had insufficient knowledge regarding truth telling, pain control and management with morphine, emergency management in terminal cancer care and treatment of fluid intake in terminal stages. Attitude and knowledge scores were statistically correlated (p=0.036). Knowledge scores were further positively associated with being taught palliative care in their medical curriculum (p=0.042). Conclusions: Formal education in palliative care and development of palliative care services are very much needed in Thailand to provide holistic care to terminally ill patients.

The analgesic efficacy of a single injection of ultrasound-guided retrolaminar paravertebral block for breast surgery: a prospective, randomized, double-blinded study

  • Hwang, Boo-Young;Kim, Eunsoo;Kwon, Jae-young;Lee, Ji-youn;Lee, Dowon;Park, Eun Ji;Kang, Taewoo
    • The Korean Journal of Pain
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    • v.33 no.4
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    • pp.378-385
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    • 2020
  • Background: The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block. Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. Methods: Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture). The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. Results: Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P = 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

Need Assessment of Home-based Cancer Patients (재가암환자 요구도 조사)

  • Kim, Tae-Sook;Yang, Byung-Guk;Jeong, Eun-Kyeong;Park, No-Rai;Lee, Young-Sook;Lee, Young-Sung;Lee, Sok-Goo;Kim, Young-Taek;Yun, Young-Ho;Huh, Gil-Ja
    • Journal of Hospice and Palliative Care
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    • v.2 no.1
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    • pp.36-45
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    • 1999
  • Purpose : Cancer, one of the major causes of death in Korea, tends to become chronic due to the rapid development of diagnostic and therapeutic methods. As a result, the number of home-based cancer patients is in the increasing trend. However, on account of the insufficiency of continuous and comprehensive cancer patient management system, a number of cancer patients are left in a defenseless state. This study was designed for need assessment of home-based cancer patient to establish the community-based health care system for the comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce rare burdens of their families. Methods : Through making a survey for needs assessment toward the health care service, the 455 respondents among home-based cancer patients answered the given enquetes to analyze the management status and problems of home-based cancer patients Results : 1) Unsatisfaction rates of pain control is 25.5 percent for mild cases, 46.5 percent for severe cases. 2) According to the needs assessment of home-based cancer patients, most of the respondents want to receive economical support, alleviation for the pain and symptoms, and the information of health care and consultation. So these needs account for the main contents of the home-based cancer patient management plan. 3) In the aspect of the satisfaction rate for basic care need, most items account for $20{\sim}30%$ of satisfaction. And the proportion of need for special case is under 5%, satisfaction rate for special care need is about 50% of satisfaction. So the home-based cancer patients are not being cared sufficiently. Conclusion : According to the result of need assessment, many home-based cancer patients received inadequate pain and symptom management. And Satisfaction rate for basic and special care need is low. So development of comprehensive and continuous health care service to improve the quality of life of cancer patients and reduce care burdens of their families is very necessary.

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