• Journal of Pharmacopuncture
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• v.17 no.3
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• pp.62-69
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• 2014

Objectives: The purpose of this study is to report a case series of advanced cancer patients whose cancer pain was relieved by using autonomic nerve pharmacopuncture (ANP) treatment. ANP is a subcutaneous injection therapy of mountain ginseng pharmacopuncture (MGP) along the acupoints on the spine (Hua-Tuo-Jia-Ji-Xue; 0.5 cun lateral to the lower border of the spinous processes of vertebrae) to enhance the immune system and to balance autonomic nerve function. Methods: Patients with three different types of cancer (gastric cancer, lung cancer, colon cancer with distant metastases) with cancer pain were treated with ANP. 1 mL of MGP was injected into the bilateral Hua-Tuo-Jia-Ji-Xue on the T1-L5 sites (total 12-20 mL injection) of each patient's dorsum by using the principle of symptom differentiation. During ANP treatment, the visual analogue scale (VAS) for pain was used to assess their levels of cancer pain; also, the dosage and the frequency of analgesic use were measured. Results: The cancer pain levels of all three patients improved with treatment using ANP. The VAS scores of the three patients decreased as the treatment progressed. The dosage and the frequency of analgesics also gradually decreased during the treatment period. Significantly, no related adverse events were found. Conclusion: ANP has shown benefit in controlling cancer pain for the three different types of cancer investigated in this study and in reducing the dosage and the frequency of analgesics. ANP is expected to be beneficial for reducing cancer pain and, thus, to be a promising new treatment for cancer pain.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.4
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• pp.2141-2144
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• 2016

Background: Many cancer patients still experience pain worldwide. There are many barriers for effective control of cancer pain and many of these are related to health care providers. There is a need for further investigation of these barriers. The aim of this study was to investigate nurse-related barriers to control of cancer pain among Iranian nurses. Materials and Methods: In this descriptive study 49 nurses from two hospitals affiliated to Tabriz and Ardebil Universities of Medical Sciences participated using a census sampling method. A demographic and profession related checklist and Barriers Questionnaire II (BQ-II) were used for data collection. Results: The results showed negative attitudes of participants regarding control of cancer pain. Participants believed that cancer pain medications do not manage cancer pain at acceptable levels; patients may become addicted by using these drugs; cancer pain medications have many uncontrollable effects; and controlling cancer pain may distract the physicians from treating disease. Conclusions: Iranian nurses have negative attitudes toward pain control in cancer patients especially about effectiveness of pain medication and their side effects. Educational intervention to reduce these misconceptions is needed.

• Physical Therapy Rehabilitation Science
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• v.10 no.3
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• pp.343-350
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• 2021

Objective: The most common type of cancer in women is breast cancer, and pain in the upper extremity and trunk is a discomfort experienced by more than half. Based on the evidence that manual therapy is effective for pain control in postoperative rehabilitation, this study aims to analyze the effects of manual therapy on upper extremity pain and function in patients after breast cancer surgery. Design: A systematic review and meta-analysis. Methods: We searched MEDLINE, Embase, PEDro, and CINAHL databases until August 2021. We included randomized controlled trial evaluating pain and function in patients after breast cancer surgery. Qualitative analysis was performed using Cochrane's risk of bias tool, and quantitative analysis was performed using RevMan 5.4 to analyze post-intervention outcomes. Results: Four randomized controlled trials were selected to evaluate the effects of upper extremity pain and function in 133 patients who underwent manual therapy after breast cancer surgery. In the results of qualitative and quantitative analysis, the experimental group treated with manual therapy showed a significant improvement in pain compared to the control group (-0.62; 95% confidence interval (CI) -0.97 to -0.27). However, there was no significant improvement in upper extremity function (-0.09; 95% CI -0.43 to 0.25). Conclusions: Current evidence shows that manual therapy is effective for pain control in patients who complain of upper extremity pain after breast cancer surgery.

• The Korean Journal of Pain
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• v.7 no.1
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• pp.1-12
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• 1994

• Korean Journal of Adult Nursing
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• v.15 no.2
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• pp.205-214
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• 2003

Purpose: This study was conducted to examine the nurses' knowledge about and attitude toward cancer pain management. Method: Study subjects of this retrospective cross-sectional survey study were 343 nurses sampled conveniently in a tertiary teaching hospital in Seoul. Seven measurement tools were used to collect data on demographic data, knowledge about and attitude toward cancer pain management, barrier to cancer pain management, knowledge about and concerns for the opioid use, and professional education of cancer pain management. Result: Nurses showed knowledge deficit when their knowledge on the cancer pain management and the opiod use was evaluated using two case scenarios and the 15-item questionnaire respectively. Ninety-five percent of the nurses believed that cancer pain management is a major problem. However, inadequate staff knowledge of pain management was rated as the single most important barrier to adequate pain management by 20.4% of nurses. Only 10.9% and 23.2% of the nurses replied that nursing school's education and professional education in cancer pain management respectively, were adequate. Conclusion: This study confirms the existence of knowledge deficits and attitudinal barriers among Korean nurses that can impede cancer pain management. This study suggests a need for professional education for nurses on cancer pain management.

• Asian Oncology Nursing
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• v.2 no.1
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• pp.36-49
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• 2002

The purpose of this study was to evaluate the effects of the pain management education on pain of the terminal cancer patients at home. For evaluating the effectiveness of the intervention modified Patient Outcome Questionnaire (APS, 1995) including patients concerns with cancer pain management, pain intensity, and interference of daily activities related to pain were measured before and after the education in control group and experimental group and the differences were compared with each other. Satisfaction with pain management was measured after the intervention. Pain management education was delivered to 16 experimental group patients by home care nurses, who were provided with 3-hour education on cancer pain management by one of the researchers. Pain management education included common misconceptions about cancer pain control and pharmacological and non-pharmacological interventions and emphasis was put on the importance of pain reports and patients' active participation in pain management. The results of the study were as follows. Patients concerns with pain management were decreased more greatly in the experimental group than those of the control group. The worst, average, and present pain intensities during the last 24 hours were decreased more greatly in the experimental group, and total score and each subcategory of the interference of daily living, except walking, were decreased more greatly in the experimental group. And satisfaction score with total pain management and nurses response to the pain reports were higher in the experimental group. The results of this study suggest that pain management education given to the patients by home care nurses is a very useful intervention to improve pain of the cancer patients at home. This positive result is thought to derive from patients' active pain report and participation in pain control and the use of powder form sustained release morphine for breakthrough pain control in part. Further studies with increased sample size from more institutions are recommended and early introduction of short acting morphine is strongly suggested for effective cancer pain control.

• The Korean Journal of Pain
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• v.12 no.2
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• pp.221-226
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• 1999

Background : Validity of WHO guideline of cancer pain management has been proven and many trials have been done to derive solutions for inadequate cancer pain management. We assessed the severity of pain of terminal cancer patients in a few different ways and patients' characteristics influencing inadequate pain management. Methods : This study was based on 100 adult oncological patients who were confirmed as terminal stage in our institution from 3/1998 to 11/1998. Medical records were reviewed and individual patients were interviewed to obtain demographic information and medical characteristics such as: daily activity performance, metastasis, and drug-adjusted pain severity. Adequacy of prescribed analgesics in accordance with WHO guidelines of pain management and patients' characteristics influencing adequacy of pain management were assessed. Results : Among those cancer patients diagnosed as terminal stage, 85% complained of pain, and 68% of those patients reported pain above moderate severity. 38% of those patients received inadequate pain management resulting in greater severity of pain; the less adequate pain relief was(p<0.01). Sex, age, primary cancer site metastasis, symptoms such as depression and anxiety, and daily activity performance were not significantly related. Conclusions : Despite WHO guidelines for pain management, majority of the terminal cancer patients received inadequate pain management. There is a necessity for education on proper pain evaluation and strict implimentation for WHO guidelines of pain management.

• The Korean Journal of Pain
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• v.10 no.2
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• pp.304-307
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• 1997

Continuous epidural infusion, a combination of local anesthetic and opioid, have been widely administered for treatment of chronic cancer pain. A serious complications of epidural block is paraplegia which can also be caused by : direct spinal cord injury, epidural hematoma, epidural abscess, ischemic change, neurotoxicity, preexisting disease. Continuous epidural block for pain control of patient with cervical cancer was performed at $T_{12}/L_1$ interspace. A 4 cm catheter was inserted cephalad into the epidural space. After four months, back pain and motor weariless of lower extremities progressively developed. Spine CT showed bony destruction and soft mass-like lesion at $T_9$ & $T_{12}$ spine. We propose paraplegia was caused by spinal cord compression which resulted from vertebral metastasis of cervical cancer.

• Journal of Yeungnam Medical Science
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• v.41 no.1
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• pp.22-29
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• 2024

Breakthrough pain is transitory pain that occurs despite the use of opioids for background pain control. Breakthrough pain occurs in 40% to 80% of patients with cancer pain. Despite effective analgesic therapy, patients and their caregivers often feel that their pain is not sufficiently controlled. Therefore, an improved understanding of breakthrough pain and its management is essential for all physicians caring for patients with cancer. This article reviews the definition, clinical manifestations, accurate diagnostic strategies, and optimal treatment options for breakthrough pain in patients with cancer. This review focuses on the efficacy and safety of rapid-onset opioids, which are the primary rescue drugs for breakthrough pain.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.5
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• pp.2619-2624
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• 2016

Background: Cancer is a worldwide health problem. Arabic countries are also concerned and the burden linked to the pain related to cancer is dsiquieting. The aim of this study is to set the panel of valid tools for assessing the multiple dimensions of pain in arabic speaking countries. Materials and Methods: A systematic review on PubMed, Scopus, and Science Direct databases was conducted using as key words cancer, pain and arabic speaking population. The content of 51 articles was studied and nine articles were retained for their relevance for the issue. Results: We founf eight different questionnaires. MSAS-Leb, EORTC-C30, EORTC-BR23, MDASI, FLIC, and COOP/WONCA are dedicated to physical and psychological dimensions of pain. BPI is centered on direct items for measuring pain accurately. ABQ-II is the unique tool focusing on barriers to cancer pain control. All tools are confirmed valid and reliable in the context studied for assessing pain and disconfort linked to cancer. Conclusions: This panel of questionnaires covers all relevant aims for assessing pain in diferent arabic speaking countries with the recommendation of a cultural adaptation to local arabic languages.