Current concepts of pain management for cancer patients

Pain management is one of the most important issues confronted when treating patients with malignant diseases. Since its release/publication in 1986, the World Health Organization’s three-step analgesic ladder has helped to greatly improve pain management in cancer patients. However, many questions...

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Main Authors: Yin-Hsun Feng, Ying-Wai Wang, Sai-Ching Jim Yeung
Format: Article
Language:English
Published: Frontiers Media S.A. 2011-12-01
Series:Oncology Reviews
Subjects:
Online Access:http://www.oncologyreviews.org/index.php/or/article/view/123
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author Yin-Hsun Feng
Ying-Wai Wang
Sai-Ching Jim Yeung
author_facet Yin-Hsun Feng
Ying-Wai Wang
Sai-Ching Jim Yeung
author_sort Yin-Hsun Feng
collection DOAJ
description Pain management is one of the most important issues confronted when treating patients with malignant diseases. Since its release/publication in 1986, the World Health Organization’s three-step analgesic ladder has helped to greatly improve pain management in cancer patients. However, many questions about this three-step analgesic ladder have been raised and its application in the clinical setting remains a controversial subject. This review article explores the frontline treatment of cancer pain with morphine and the different routes of fentanyl administration used in cancer pain management. The combination of multiple opiates/opioids has been shown to result in more effective cancer pain management; however, the exact benefits of such opiate/opioid combinations have yet to be established. This article also discusses recent advances in the topical application of morphine and in the combination of ketamine and morphine. It explores the updated treatment principles of neuropathic pain in advanced-stage cancer patients, which incorporate the use of anti-depressants, anti-convulsants, and opioids. Finally, this article reviews the available data and clarifies the general principles for using opioids in cancer patients with renal insufficiency. We hope that this information will be helpful in improving pain management in cancer patients and in facilitating further research.
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spelling doaj.art-bbdf61cabde14925807a5955d6a128bb2023-01-03T10:57:08ZengFrontiers Media S.A.Oncology Reviews1970-55571970-55652011-12-012310.4081/oncol.2008.154117Current concepts of pain management for cancer patientsYin-Hsun Feng0Ying-Wai Wang1Sai-Ching Jim Yeung2Chi-Mei Medical Center, Liouying Campus; Institute of Clinical Medicine, Medical School, National Cheng Kung University, TainanHospice Unit, Tzu Chi University, School of Medicine, HualienDepartment of General Internal Medicine, Ambulatory Treatment and Emergency Care, The University of Texas M.D. Anderson Cancer Center, Holcombe HoustonPain management is one of the most important issues confronted when treating patients with malignant diseases. Since its release/publication in 1986, the World Health Organization’s three-step analgesic ladder has helped to greatly improve pain management in cancer patients. However, many questions about this three-step analgesic ladder have been raised and its application in the clinical setting remains a controversial subject. This review article explores the frontline treatment of cancer pain with morphine and the different routes of fentanyl administration used in cancer pain management. The combination of multiple opiates/opioids has been shown to result in more effective cancer pain management; however, the exact benefits of such opiate/opioid combinations have yet to be established. This article also discusses recent advances in the topical application of morphine and in the combination of ketamine and morphine. It explores the updated treatment principles of neuropathic pain in advanced-stage cancer patients, which incorporate the use of anti-depressants, anti-convulsants, and opioids. Finally, this article reviews the available data and clarifies the general principles for using opioids in cancer patients with renal insufficiency. We hope that this information will be helpful in improving pain management in cancer patients and in facilitating further research.http://www.oncologyreviews.org/index.php/or/article/view/123Cancer pain - WHO analgesic ladder - Opiate - Side effect
spellingShingle Yin-Hsun Feng
Ying-Wai Wang
Sai-Ching Jim Yeung
Current concepts of pain management for cancer patients
Oncology Reviews
Cancer pain - WHO analgesic ladder - Opiate - Side effect
title Current concepts of pain management for cancer patients
title_full Current concepts of pain management for cancer patients
title_fullStr Current concepts of pain management for cancer patients
title_full_unstemmed Current concepts of pain management for cancer patients
title_short Current concepts of pain management for cancer patients
title_sort current concepts of pain management for cancer patients
topic Cancer pain - WHO analgesic ladder - Opiate - Side effect
url http://www.oncologyreviews.org/index.php/or/article/view/123
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