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Regenerative Medicine in Pain Management
Published in Sahar Swidan, Matthew Bennett, Advanced Therapeutics in Pain Medicine, 2020
Sharon McQuillan, Rafael Gonzalez
Pain resulting from cancer is a very common ailment. Cancer-related pain is experienced by 55% of patients undergoing treatments and by 66% of patients who have advanced, metastatic, or terminal disease.82 Cancer pain is either a direct effect of the disease, such as nerve compression, or tumor extension into the tissue or bone, or the pain is related to treatment side effects such as chemotherapy-induced peripheral neuropathy, nerve injury, or lymphedema. The gold standard for cancer pain treatment is pharmaceutical intervention, in the form of opioids, steroids, antidepressants, and anticonvulsants. Many of these medications are accompanied by undesirable side effects.
Palliative care
Published in Peter Hoskin, Peter Ostler, Clinical Oncology, 2020
Cancer pain is a chronic pain distinct from that associated with acute events such as trauma, post-operative pain or a toothache. An important feature for its management is that it will often be associated with a significant emotional component alongside the physical cause of pain. Most cancer patients have associated anxiety, fear, depression and anger, which will modulate their perception of pain and attention to these features will be of equal importance to the use of analgesic drugs. Three components to the pain of advanced cancer have been described: PhysicalEmotionalSpiritual
Cancer-Related Pain
Published in Andrea Kohn Maikovich-Fong, Handbook of Psychosocial Interventions for Chronic Pain, 2019
Jinsoon Lee, Amy Wachholtz, Beverly S. Shieh, Michael Tees
A patient’s negative affect, as well as maladaptive thoughts and beliefs about cancer pain management, may lead to increased pain intensity and increased use of pain medications. A systematic review indicated that cancer patients’ misconceptions or maladaptive thoughts toward cancer pain management mediate their analgesic use and ability to communicate effectively with treatment providers about pain, which in turn impacts their ability to manage cancer pain (Jacobsen, Møldrup, Christrup, & Sjøgren, 2009). Specifically, cancer patients’ cognitive factors mediating pain management include knowledge, beliefs, attitudes, and concerns about treatment or medication for cancer-related pain (Davis & Walsh, 2004; Sun et al., 2007). For example, if patients believe that a cancer diagnosis means they need to quit their job, lose their friends, and die alone (despite their treatment team providing information to the contrary), then they are more likely to have stronger pain experiences and request more analgesic medications.
The state-of-the-art pharmacotherapeutic options for the treatment of chronic non-cancer pain
Published in Expert Opinion on Pharmacotherapy, 2022
Ryan S. D’Souza, Brendan Langford, Rachel E. Wilson, Yeng F. Her, Justin Schappell, Jennifer S. Eller, Timothy C. Evans, Jonathan M. Hagedorn
Historically, opioid medications were extensively utilized for treatment of chronic non-cancer pain. Prescription-related opioid use disorder prevalence tripled from 1991 to 2013 [2]. Furthermore, new opioid medications have recently been approved by the United States Food and Drug Administration (FDA), such as oliceridine [3]. However, given the opioid epidemic and the disadvantages associated with use of opioid for chronic pain, there has been an increasing emphasis on multimodal analgesia [4,5]. Multimodal analgesia is defined as the administration of multiple medications each with a unique mechanism of action which when administered concomitantly may provide profound analgesia [4,5]. This strategy is further supported by studies reporting that perception of pain may be transmitted and modulated through many different receptors, such as opioid receptor (mu, delta, kappa, and other types), adrenergic receptor, N-methyl-D-aspartate (NMDA) channel, sodium and calcium channels, and many other types of receptors [6].
A narrative review of buprenorphine in adult cancer pain
Published in Expert Review of Clinical Pharmacology, 2020
Matthew Degnan, Shaker A. Mousa
Cancer-associated pain can have many causes, which makes management a multifaceted and complex task. The most common type of pain experienced by patients with cancer is somatic pain, and this is most commonly caused by a solid tumor [7]. Cancer pain is constant and needs well-managed relief using various approaches. A related origin of pain in solid tumor cancers is postoperative pain. However, while not all cancers have solid tumors, pain of different etiologies can still be common. Understanding the etiology and pathophysiology of the pain a patient is experiencing is fundamental for adequate treatment. The current understanding of the pathophysiologic pathways involved in adult cancer pain are associated with cancer and its therapy. Concomitant use of pain relief with anticancer medications dictate the use of analgesics with the fewest drug-drug interactions and the most favorable metabolic and excretion profiles.
Integrating Clinical Hypnosis and Neurofeedback
Published in American Journal of Clinical Hypnosis, 2019
The Sellick and Zaza (1998) review of five alternative medicine strategies for management of cancer pain found only one randomized controlled study for acupuncture, one for massage therapy, and none for therapeutic touch, acupuncture, or biofeedback, but six for hypnosis. The 12-member National Institutes of Health Technology Assessment Panel on Integration of Behavioral and Relaxation Approaches into the Treatment of Chronic Pain and Insomnia (1996), following an extensive literature search, concluded, “The evidence supporting the effectiveness of hypnosis in alleviating chronic pain associated with cancer seems strong” (p. 315). Hypnosis is also well established as a treatment for managing nausea and vomiting associated with chemotherapy (Liossi & White, 2001; Syrjala, Cummings, & Donaldson, 1992; Walker, 1998; Walker et al., 1999; Zeltzer, Dolgin, LeBaron, & LeBaron, 1991; Zeltzer, LeBaron, & Zeltzer, 1984). A large body of controlled research has also documented the effectiveness of hypnosis in the treatment of headache and migraine (Hammond, 2007a).