Updates in Palliative Care - Overview and Recent Advancements in the Pharmacological Management of Cancer Pain
Overview
Affiliations
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made. For opioid analgesics, side effects of opioids are discussed alongside practical guidance on opioid prescribing and converting between opioids. Newer drugs such as tapentadol are considered in this update. Amitriptyline, duloxetine, gabapentin and pregabalin, and the guidance for their use are reviewed in the coanalgesics (adjuvants) section.
Uhlig S, Doberschutz F, Hallmann F, Salm H, Sigle J, Pink D Support Care Cancer. 2024; 32(8):491.
PMID: 38976073 PMC: 11231016. DOI: 10.1007/s00520-024-08671-4.
Silva J, Filho J, Acha B, Almeida F, Batista E, Rodrigues Silva V Pharmaceuticals (Basel). 2024; 17(5).
PMID: 38794204 PMC: 11124378. DOI: 10.3390/ph17050633.
Experiences of patients with advanced cancer coping with chronic pain: a qualitative analysis.
Xia W, Ou M, Chen Y, Chen F, Yan M, Xiao Z BMC Palliat Care. 2024; 23(1):94.
PMID: 38600476 PMC: 11005139. DOI: 10.1186/s12904-024-01418-2.
Effects of Opioids on Immune and Endocrine Function in Patients with Cancer Pain.
Bradley A, Boland J Curr Treat Options Oncol. 2023; 24(7):867-879.
PMID: 37145383 PMC: 10271882. DOI: 10.1007/s11864-023-01091-2.
Moxibustion as an Adjuvant Therapy for Cancer Pain: A Systematic Review and Meta-Analysis.
Li Y, Hong E, Ye W, You J J Pain Res. 2023; 16:515-525.
PMID: 36824500 PMC: 9942498. DOI: 10.2147/JPR.S396696.