• Title/Summary/Keyword: cancer pain

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Pharmacoeconomics Evaluation of Morphine, MS Contin and Oxycodone in the Treatment of Cancer Pain

  • Zhang, Wen-Zhou;Yu, Wei-Jiang;Zhao, Xiu-Li;He, Bao-Xia
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.20
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    • pp.8797-8800
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    • 2014
  • Objective: To analyze cost-effectiveness of morphine, MS contin and oxycodone in the treatment of cancer pain, providing guidance for rational drug use in the clinic. Methods: Confirmed by histology, a total of 171 patients with various cancers who required analgesic treatment were selected and divided into 3 groups, 57 cases for each group, given morphine, MS contin and oxycodone, respectively. If there appeared a poor short-term effect or aggravated sudden pain during the treatment, a short-acting morphine injection was given and adverse reactions were processed by symptomatic treatment. The pain relief rate and adverse reactions of groups were observed and pharmacoeconomics evaluation was undertaken. Results: The pain relief rates with morphine, MS contin and oxycodone were 89.5%(51/57), 91.2%(52/57) and 93.0%(53/57), respectively, with no difference samong groups (${\chi}^2=4.4489$, P=0.6162). The occurrence rates of adverse reactions were 59.7%(34/57), 54.4%(31/57) and 43.9%(25/57), again with no significant variation (P>0.05). The ratios of cost-effectiveness (C/E) for the 3 groups were $14.6{\pm}7.21$, $15.0{\pm}7.44$ and $16.1{\pm}8.10$. When the price of 3 kinds of analgesics was reduced by 10%, the ratios of cost-effectiveness were $12.2{\pm}6.53$, ($13.4{\pm}6.08$ and $14.5{\pm}6.74$ but there was no differences when compared with before the price adjustment (t=1.86, P=0.0651; t=1.30, P=0.1948; t=1.17, P=0.2453). Conclusion: Morphine, MS contin and oxycodone give similar pain relief and adverse reaction rates but of all, morphine is the preferred drug for the treatment of cancer pain from the perspective of pharmacoeconomics.

Pain and Factors Influencing Its Management in Patients with Terminal Cancer (말기 암환자의 통증 및 통증관리에 영향을 미치는 요인)

  • Yun, Young-Ho;Heo, Dae-Seog;Kim, Hong-Soo;Ou, Sang-Woo;Yoo, Tai-Woo;Kim, You-Young;Huh, Bong-Yul
    • Journal of Hospice and Palliative Care
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    • v.1 no.1
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    • pp.23-29
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    • 1998
  • Purpose : Validity of WHO guideline of cancer pain management has been proven and many trials were done for resolution of inadequate management of cancer pain. We assessed the severity of pain in terminal cancer patients and patient's characteristics influencing inadequate pain management. Methods : This study was done on 100 patients who was confirmed as terminal in Seoul National University Hospital from lune 1997 to November. For getting the informations about dermographic and medical characteristics such as performance and metastasis, and drug-adjusted pain severity the patients, we reviewed the medical records and interview the patients. we assessed the adequacy of prescribed analgesics with WHO guidelines of pain management, and patient's characteristics influencing on adequacy of pain management. Results : 85.0 percent of cancer patient had pain when diagnosed as terminal cancer and 68% of patient had pain above moderate severity. 38.0 percent of those were given inadequate pain management and the greater pain severity, the less adequate(P<0.001). Sex, age, primary site of cancer, metastasis, symptoms such as depression and anxiety, and performance were not significant. Conclusion : Despite guidelines for pain management, many patients with terminal cancer received inadequate pan management. Their is a need for education about evaluation of pain and guidelines of pain management.

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Effectiveness of $Myprodol^{(R)}$ in ram Management (통증 조절에 있어서 $Myprodol^{(R)}$의 효과)

  • Shin, Sang-Wook;Lee, Hyun-Sub;Kim, Inn-Se;Baik, Seong-Wan
    • Journal of Hospice and Palliative Care
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    • v.4 no.1
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    • pp.41-46
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    • 2001
  • Background : Many analgesics are used to relieve the pain of various causes. Among these, $Myprodol^{(R)}$, a combination analgesic with codeine, ibuprofen and paracetamol, was recently used as a new analgesics. This study was performed to survey the kinds of diseases, side effects and pain relief effect of $Myprodol^{(R)}$ in clincal practice. Methods : This retrograde study surveyed the medical records of 183 patients treated with $Myprodol^{(R)}$ at Pain Clinic, Pusan National University Hospital. From medical records, the disease entities, the pain characteristics, duration of $Myprodol^{(R)}$ medication, the analgesic effect and side effects were evaluated. Results : $Myprodol^{(R)}$ is used in the treatment of cancer pain (64.3%) and non-cancer pain (35.7%). Among side effects of $Myprodol^{(R)}$ medication, nausea with vomiting, constipation and generalized edema were common in cancer pain, but epigatric pain was common in non cancer pain. $Myprodol^{(R)}$ was more effective in non cancer pain than cancer pain. Conclusions: $Myprodol^{(R)}$ was used in cancer and non-cancer pain patients. In cancer pain patients, $Myprodol^{(R)}$ was effective in early cancer pain but, not effective in advanced cancer. $Myprodol^{(R)}$ was also used and effective in non-malignant benign chest pain, lumbago, post-operative pain.

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A positive feedback loop of heparanase/syndecan1/nerve growth factor regulates cancer pain progression

  • Xiaohu Su;Bingwu Wang;Zhaoyun Zhou;Zixian Li;Song Tong;Simin Chen;Nan Zhang;Su Liu;Maoyin Zhang
    • The Korean Journal of Pain
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    • v.36 no.1
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    • pp.60-71
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    • 2023
  • Background: The purpose of this research was to assess the role of heparanase (HPSE)/syndecan1 (SDC1)/nerve growth factor (NGF) on cancer pain from melanoma. Methods: The influence of HPSE on the biological function of melanoma cells and cancer pain in a mouse model was evaluated. Immunohistochemical staining was used to analyze HPSE and SDC1. HPSE, NGF, and SDC1 were detected using western blot. Inflammatory factors were detected using ELISA assay. Results: HPSE promoted melanoma cell viability, proliferation, migration, invasion, and tumor growth, as well as cancer pain, while SST0001 treatment reversed the promoting effect of HPSE. HPSE up-regulated NGF, and NGF feedback promoted HPSE. High expression of NGF reversed the inhibitory effect of HPSE down-regulation on melanoma cell phenotype deterioration, including cell viability, proliferation, migration, and invasion. SST0001 down-regulated SDC1 expression. SDC1 reversed the inhibitory effect of SST0001 on cancer pain. Conclusions: The results showed that HPSE promoted melanoma development and cancer pain by interacting with NGF/SDC1. It provides new insights to better understand the role of HPSE in melanoma and also provides a new direction for cancer pain treatment.

Blockade of Ganglion Impar and Superior Hypogastric Plexus Block for Perineal Cancer Pain -Case report- (회음부 암성통증에 대한 외톨이 신경절 블록과 상 하복 신경총 블록 -증례 보고-)

  • Han, Seung-Yeon;Yoon, Duck-Mi
    • The Korean Journal of Pain
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    • v.12 no.2
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    • pp.238-241
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    • 1999
  • Intractable pain arising from disorders of the viscera and somatic structures within the pelvis and perineum often poses difficult problems for the pain pratitioner. The reason for this difficulty is that the region contains diverse anatomic structures with mixed somatic, visceral, and autonomic innervation affecting bladder and bowel control and sexual function. Clinically, sympathetic pain in the perineum has a distinctly vague, burning, and poorly localized quality and is frequently associated with the sensation of urgency. Although various approaches have been proposed for the management of intractable perineal pain, their efficacy and applications are limited. Historically, neurolytic blockade in this region has been focused mainly on somatic rather than sympathetic components. The efficacy of neurolytic ganglion impar block has been demonstrated in treating perineal pain without significant somatovisceral dysfunctions for patient with advanced cancer in 1990. The introduction of superior hypogastric plexus block in 1990 demonstrated its effectiveness in patients with cancer related pelvic pain. In our report, five patients had advanced cancer (rectal caner 3; cervix cancer 1; metastases to sacral portion of renal cell cancer 1). Localized perineal pain was present in all cases and was characterized as burning and urgent with 9~10/10 pain intensity. After neurolytic block of ganglion impar, patients experiened incomplete pain reduction (7~8/10), as determined by the VAS (visual analogue scale), and change in pain site. We then treated with superior hypogastric plexus block, which produced satisfactory pain relief (to less than 4/10), without complication.

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Pain Management for Cancer Patients (암 환자를 위한 통증 관리)

  • Hwang, Kyoo-Hyun
    • The Korean Journal of Pain
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    • v.3 no.1
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    • pp.11-14
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    • 1990
  • Thirty-two cancer patients were treated with various pain control methods. In those who had localized pain or more than 1 year life expectancy. The author preferred neurolytic blockade for whom had localized pain or had more than 1 year life-expectancy to epidural or intrathecal narcotics. The latter methods were saved as a last resort. Effective pain relief was achieved in over 80% of those treated. There were no serious complications. Of the 12 epidural or intrathecally implanted catheter with subcutaneous tunneling cases, successful pain management was possible throughout the remainder of life which was from 1 week to 6 months.

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Effects of a Tailored Education and Coaching Program to Enhance Care of Cancer-related Pain (맞춤형 암성통증관리 개별교육 및 코칭의 효과)

  • Kim, Hye Jin;Kim, Young Mee;Kim, Hee Jin
    • Journal of muscle and joint health
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    • v.27 no.1
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    • pp.12-21
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    • 2020
  • Purpose: The study was to develop a tailored education and coaching program (TECP) for cancer patients, and to identify the effects of TECP on pain severity, daily living impairment, barriers on pain management, self-efficacy, and pain management satisfaction. Methods: A randomized controlled trial was used. Patients referred to an oncology nurse specialist from oncologists for pain management were randomly assigned to TECP (25) or usual education program (UEP, 22). The intervention was offered by educating the method of taking opioid medication, managing opioid-induced side effects, reducing pain misconceptions and enhancing self-efficacy for communicating with a medical team on cancer pain severity, and pain-related impairment. Patients completed questionnaires before the education program and on the next visit 3~4 weeks later. Data were analyzed by SPSS 19.0 program using percentage, frequency, mean, standard deviation, x2 test and independent t-test. Results: At all levels, pain severity improved significantly in the experimental group-worst pain (8.16 to 3.80, p<.001), average pain (6.16 to 2.52 p=.008), and least pain (3.32 to 0.96, p=.038)-but not in the control group. Pain management satisfaction also showed significant differences (t=2.93, p=.005) between experimental (4.70±0.49) and control (4.17±0.73) groups. Interference with daily living, barriers to managing cancer pain, and self-efficacy for managing pain improved in both groups but there were no significant differences. Conclusion: The findings suggest that TECP should be considered for outpatients who need cancer pain management.

Relationships among Pain, Upper Extremity Function, and Anxiety in the Breast Cancer Survivors (유방암 생존자의 상지기능, 통증 및 불안과의 관계)

  • Lim, Jeong-Sun;Kim, Jong-Im
    • Journal of muscle and joint health
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    • v.19 no.1
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    • pp.37-45
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    • 2012
  • Purpose: This study was to compare pain, upper extremity function, and anxiety among disease characteristics in the breast cancer survivors and to clarify the relationship among these variables. Methods: One hundred twenty two participants with breast cancer survivors over the age of 30 were recruited from a general hospital. Data were collected from November 1 to December 25, 2006 using a structured questionnaire. Results: The mean age was 51.17 and their mean survival period was 38.08 months. The breast cancer survivors who had received radiation therapy reported lower levels of pain and upper extremity function, and higher levels of anxiety than those who had other treatments. Pain and anxiety were positively related, and upper extremity function was negatively related to pain and anxiety. Conclusion: The breast cancer survivors experienced pain, upper extremity function disorder and anxiety. This study indicates that nursing interventions for the breast cancer survivors may be needed to improve upper extremity function, and to reduce pain and anxiety.

Knowledge and Attitude toward Cancer Pain Management: Clinical Nurses Versus Doctors (간호사와 의사의 암성 통증관리에 대한 지식과 태도)

  • Jun, Myung-Hee;Gong, Sung-Hwa;Lee, Seon-Hee;Kim, Yeon-Hee;Choi, Jin-Sun;Park, Kyeong-Soon
    • The Journal of Korean Academic Society of Nursing Education
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    • v.12 no.1
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    • pp.115-123
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    • 2006
  • Purpose: This study is purposed to provide basic data needed in constructing the educational contents about cancer pain management for the health care professionals. Methods: This study surveyed the degree of knowledge in cancer pain management of clinical nurses and doctors. Subjects were clinical 143 nurses and 88 doctors in 3 cities. The tool used are 32-item scale for evaluation of health care professionals' knowledge modified by Kim(1997), which was originally developed by McCaffery and Ferrel(1995). Results: The level of the health care professionals' knowledge about and attitude toward pain management were insufficient. The level of the doctors' knowledge and attitude showed higher score than those of the nurses'. The knowledge of health professional who were not hesitated to administrate analgesia was showed more higher than who were hesitated to do. Conclusion: Nurses need more knowledge and effective attitude toward cancer pain management. Various and sufficient educational program about cancer pain management can be contribute to improve the nursing quality of cancer pain.

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Impacts of Fatigue, Pain, Anxiety, and Depression on the Quality of Life in Patients with Breast Cancer (유방암 환자의 피로, 통증, 불안, 우울이 삶의 질에 미치는 영향)

  • Byun, Hye-Sun;Kim, Gyung-Duck
    • Asian Oncology Nursing
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    • v.12 no.1
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    • pp.27-34
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    • 2012
  • Purpose: This study was conducted to identify the impact of fatigue, pain, anxiety and depression on the quality of life (QOL) among breast cancer patients. Methods: This study was conducted from July 12th to July 20th, 2010. One hundred and fifty breast cancer patients were recruited from D city in Korea. The instruments used in this study were the fatigue, pain, anxiety, depression and the quality of life scales for patients with breast cancer. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlation coefficients and multiple regression with the SPSS/WIN 12.0 program. Results: The quality of life for cancer patients showed a significant relationship with fatigue, pain, anxiety and depression. The significant factors influencing quality of life were fatigue, pain, anxiety and depression that explained 65.6% of the variance. Conclusion: Patients with breast cancer experienced fatigue, pain, anxiety and depression which led to a negative effect on quality of life. The results suggest that intervention programs to reduce fatigue, pain, anxiety and depression could improve the quality of life for breast cancer patients.