A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker

Background: The number of patients with cancer and end-stage renal disease is increasing because of the success of hemodialysis treatment. However, methods for monitoring opioids to control severe pain induced by cancer remain unsatisfactory. Case Presentation: A 72-year-old male, with a history of...

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Main Authors: Yoshihisa Mimura, Yosuke Sugiyama, Taku Naiki, Tomoya Kataoka, Yoshihiko Tasaki, Toshiki Etani, Nami Tomiyama, Nayuka Matsuyama, Kunihiro Odagiri, Kazunori Kimura, Takahiro Yasui
Format: Article
Language:English
Published: Elsevier 2022-09-01
Series:Current Problems in Cancer: Case Reports
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2666621922000436
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author Yoshihisa Mimura
Yosuke Sugiyama
Taku Naiki
Tomoya Kataoka
Yoshihiko Tasaki
Toshiki Etani
Nami Tomiyama
Nayuka Matsuyama
Kunihiro Odagiri
Kazunori Kimura
Takahiro Yasui
author_facet Yoshihisa Mimura
Yosuke Sugiyama
Taku Naiki
Tomoya Kataoka
Yoshihiko Tasaki
Toshiki Etani
Nami Tomiyama
Nayuka Matsuyama
Kunihiro Odagiri
Kazunori Kimura
Takahiro Yasui
author_sort Yoshihisa Mimura
collection DOAJ
description Background: The number of patients with cancer and end-stage renal disease is increasing because of the success of hemodialysis treatment. However, methods for monitoring opioids to control severe pain induced by cancer remain unsatisfactory. Case Presentation: A 72-year-old male, with a history of hemodialysis induced by diabetic nephropathy for 16 years and prostate cancer for three years, was diagnosed with metastasis in his 12th thoracic and 2nd lumbar vertebrae, and treated with analgesic pain management (oxycodone, acetaminophen, and pregabalin) and radiotherapy. Case management and outcome: Concern about poor pain control induced by the instability of blood opioid levels caused by hemodialysis meant the serum concentration of oxycodone was measured pre- and post-dialysis. Since the impact of pain on daily life cannot be fully assessed by pain score questionnaires, we also monitored patient activity using a wrist band-type activity tracker. A pain numeric rating score was used. Inter-day variations in the number of steps per day were observed. The relationship between pain score and blood concentrations of oxycodone pre- and post-dialysis was analyzed. The serum concentration of oxycodone was stable, even after hemodialysis, and the patient's pain gradually decreased. Conclusion: By monitoring the serum concentration of oxycodone, we obtained good pain control for bone metastasis in a patient with prostate cancer undergoing dialysis. We also monitored physical activity using an activity tracker. These findings might be useful in the selection of analgesics during the control of cancer pain in dialysis patients and allow for the objective management of opioid dosage.
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spelling doaj.art-966b9fcc12c74a27818894f938bba3832022-12-22T04:05:32ZengElsevierCurrent Problems in Cancer: Case Reports2666-62192022-09-017100179A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity trackerYoshihisa Mimura0Yosuke Sugiyama1Taku Naiki2Tomoya Kataoka3Yoshihiko Tasaki4Toshiki Etani5Nami Tomiyama6Nayuka Matsuyama7Kunihiro Odagiri8Kazunori Kimura9Takahiro Yasui10Department of Pharmacy, Nagoya City University Hospital, Aichi, Japan; Department of Hospital Pharmacy, Nagoya City University, Graduate School of Pharmaceutical Sciences, Aichi, JapanDepartment of Pharmacy, Nagoya City University Hospital, Aichi, Japan; Department of Clinical Pharmaceutics, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanFaculty of Pharmacy, Chiba Institute of Science, Chiba, JapanDepartment of Pharmacy, Nagoya City University Hospital, Aichi, Japan; Department of Clinical Pharmaceutics, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Pharmacy, Nagoya City University Hospital, Aichi, JapanDepartment of Pharmacy, Nagoya City University Hospital, Aichi, Japan; Department of Hospital Pharmacy, Nagoya City University, Graduate School of Pharmaceutical Sciences, Aichi, Japan; Department of Clinical Pharmaceutics, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanDepartment of Nephro-urology, Nagoya City University, Graduate School of Medical Sciences, Aichi, JapanBackground: The number of patients with cancer and end-stage renal disease is increasing because of the success of hemodialysis treatment. However, methods for monitoring opioids to control severe pain induced by cancer remain unsatisfactory. Case Presentation: A 72-year-old male, with a history of hemodialysis induced by diabetic nephropathy for 16 years and prostate cancer for three years, was diagnosed with metastasis in his 12th thoracic and 2nd lumbar vertebrae, and treated with analgesic pain management (oxycodone, acetaminophen, and pregabalin) and radiotherapy. Case management and outcome: Concern about poor pain control induced by the instability of blood opioid levels caused by hemodialysis meant the serum concentration of oxycodone was measured pre- and post-dialysis. Since the impact of pain on daily life cannot be fully assessed by pain score questionnaires, we also monitored patient activity using a wrist band-type activity tracker. A pain numeric rating score was used. Inter-day variations in the number of steps per day were observed. The relationship between pain score and blood concentrations of oxycodone pre- and post-dialysis was analyzed. The serum concentration of oxycodone was stable, even after hemodialysis, and the patient's pain gradually decreased. Conclusion: By monitoring the serum concentration of oxycodone, we obtained good pain control for bone metastasis in a patient with prostate cancer undergoing dialysis. We also monitored physical activity using an activity tracker. These findings might be useful in the selection of analgesics during the control of cancer pain in dialysis patients and allow for the objective management of opioid dosage.http://www.sciencedirect.com/science/article/pii/S2666621922000436Prostate cancerHemodialysisOxycodoneActivity tracker
spellingShingle Yoshihisa Mimura
Yosuke Sugiyama
Taku Naiki
Tomoya Kataoka
Yoshihiko Tasaki
Toshiki Etani
Nami Tomiyama
Nayuka Matsuyama
Kunihiro Odagiri
Kazunori Kimura
Takahiro Yasui
A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
Current Problems in Cancer: Case Reports
Prostate cancer
Hemodialysis
Oxycodone
Activity tracker
title A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
title_full A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
title_fullStr A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
title_full_unstemmed A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
title_short A rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
title_sort rare case of successful pain control in a prostate cancer patient with bone metastasis undergoing hemodialysis by measuring the serum oxycodone level and using an activity tracker
topic Prostate cancer
Hemodialysis
Oxycodone
Activity tracker
url http://www.sciencedirect.com/science/article/pii/S2666621922000436
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