Advances in Cancer Pain Management

Overview

Journal Curr Pain Headache Rep

Date 2001 Apr 20

PMID 11309214

Citations 3

Authors

F J McDonnell

J W SLOAN

S R Hamann

Affiliations

Soon will be listed here.

Abstract

Control of malignant pain and related symptoms is paramount to clinical success in caring for cancer patients. To achieve the best quality of life for patients and families, oncologists and palliative care clinicians must work together to understand problems related to psychologic, social, and spiritual pain. Pain is the primary problem targeted for control using the World Health Organization's (WHO) analgesic ladder. This article focuses on increased knowledge of analgesic action that may enable expansion of the WHO analgesic ladder to fulfill the broader objectives of palliative medicine. We discuss clinical experience with several classes of drugs that are currently used to treat cancer pain: 1) nonsteroidal anti-inflammatory drugs, with emphasis on cyclooxygenase-2 inhibitors; 2) opioid analgesics, with specific emphasis on methadone and its newly recognized value in cancer pain; 3) ketamine, an antagonist at N-methyl-d-aspartate receptors; and 4) bisphosphonates, used for pain resulting from bone metastases. New concepts that compare molecular actions of morphine at excitatory opioid receptors, and methadone at nonopioid receptor systems, are presented to underscore the importance of balancing central nervous system excitatory (anti-analgesic) versus inhibitory (analgesic) influences.

Citing Articles

The history of cancer pain and bone-targeted agents: 10 most commonly asked questions.

Vieira C, Fragoso M, Ferreira M, Pereira F, Pereira D, Medeiros R Cancer Manag Res. 2018; 11:37-46.

PMID: 30588109 PMC: 6302803. DOI: 10.2147/CMAR.S174731.

Spinal cord NMDA receptor-mediated activation of mammalian target of rapamycin is required for the development and maintenance of bone cancer-induced pain hypersensitivities in rats.

Shih M, Kao S, Wang W, Yaster M, Tao Y J Pain. 2012; 13(4):338-49.

PMID: 22341316 PMC: 3321092. DOI: 10.1016/j.jpain.2011.12.006.

An open-label, 1-year extension study of the long-term safety and efficacy of once-daily OROS(R) hydromorphone in patients with chronic cancer pain.

Hanna M, Tuca A, Thipphawong J BMC Palliat Care. 2009; 8:14.

PMID: 19754935 PMC: 2753576. DOI: 10.1186/1472-684X-8-14.

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