1
|
Wang J, Zheng G, Wang L, Meng L, Ren J, Shang L, Li D, Bao Y. Dysregulation of sphingolipid metabolism in pain. Front Pharmacol 2024; 15:1337150. [PMID: 38523645 PMCID: PMC10957601 DOI: 10.3389/fphar.2024.1337150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2023] [Accepted: 02/27/2024] [Indexed: 03/26/2024] Open
Abstract
Pain is a clinical condition that is currently of great concern and is often caused by tissue or nerve damage or occurs as a concomitant symptom of a variety of diseases such as cancer. Severe pain seriously affects the functional status of the body. However, existing pain management programs are not fully satisfactory. Therefore, there is a need to delve deeper into the pathological mechanisms underlying pain generation and to find new targets for drug therapy. Sphingolipids (SLs), as a major component of the bilayer structure of eukaryotic cell membranes, also have powerful signal transduction functions. Sphingolipids are abundant, and their intracellular metabolism constitutes a huge network. Sphingolipids and their various metabolites play significant roles in cell proliferation, differentiation, apoptosis, etc., and have powerful biological activities. The molecules related to sphingolipid metabolism, mainly the core molecule ceramide and the downstream metabolism molecule sphingosine-1-phosphate (S1P), are involved in the specific mechanisms of neurological disorders as well as the onset and progression of various types of pain, and are closely related to a variety of pain-related diseases. Therefore, sphingolipid metabolism can be the focus of research on pain regulation and provide new drug targets and ideas for pain.
Collapse
Affiliation(s)
- Jianfeng Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Guangda Zheng
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linfeng Wang
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Linghan Meng
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Juanxia Ren
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Lu Shang
- Liaoning University of Traditional Chinese Medicine, Shenyang, Liaoning Province, China
| | - Dongtao Li
- Department of Oncology, Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | | |
Collapse
|
2
|
Jin H, Liang J, Zhang S, Ma S, Qin H, Zhang D, Pang X, Zhang M. External treatment of traditional Chinese medicine for cancer pain: A systematic review and network meta-analysis. Medicine (Baltimore) 2024; 103:e37024. [PMID: 38394488 DOI: 10.1097/md.0000000000037024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/25/2024] Open
Abstract
BACKGROUND Cancer pain is one of the most intolerable and frightening symptoms of cancer patients. However, the clinical effect of the three-step analgesic ladder method (TSAL) is not satisfactory. The combination of external treatment of traditional Chinese medicine (TCM) can improve the clinical effect. OBJECTIVE This study used network meta-analysis to compare the effects of different external treatment methods of TCM combined with TSAL on cancer pain. METHODS Databases searched by our team included Google Scholar, Web of Science, Scopus, Embase, PubMed, and Cochrane Library. Randomized controlled trials related to the external treatment of TCM combined with TSAL for cancer pain were screened from the establishment of the database till now. The above literature extracted clinical efficacy, NRS score, KPS score, analgesic onset time, and duration as the main results after the screening. The 95% confidence interval (95% CI) of OR value and SMD value was used as the effect index to compare the difference in efficacy of different interventions, and the ranking was conducted. STATA 17.0 software was used for the statistical analysis of the above data. RESULTS A total of 78 studies were included, including 8 interventions and 5742 participants. Based on ranking probability, the clinical effective rate of manual acupuncture combined with TSAL was the best when the intervention time was set at 4 weeks [OR = 5.42, 95% CI (1.99,14.81)], and the improvement effect on KPS score was also the best [SMD = 0.97, 95% CI (0.61, 1.33)]. Acupoint external application was the best intervention in reducing NRS score [SMD = -1.14, 95% CI (-1.90, -0.93)]. Acupoint moxibustion combined with TSAL was considered to be the most effective intervention to prolong the duration of analgesia [SMD = 1.69, 95% CI (0.84, 2.54)] and shortening the onset time of analgesia [SMD = -3.00, 95% CI (-4.54, -1.47)]. CONCLUSIONS TSAL combined with manual acupuncture is the best in terms of clinical efficacy and improvement of patients' functional activity status. With the extension of treatment time, the intervention of this kind of treatment on the clinical effect is more pronounced. Acupoint external application also has a unique advantage in reducing the pain level of patients. From the point of view of analgesic duration and duration of analgesia, combined acupoint moxibustion has the best effect.
Collapse
Affiliation(s)
- Hong Jin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Ji Liang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Siqi Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Shuai Ma
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Hongyu Qin
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Dongxu Zhang
- Heilongjiang University of Chinese Medicine, Harbin, China
| | - Xueying Pang
- Oncology Department, The First Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| | - Miao Zhang
- Acupuncture and Moxibustion Consulting Room No. 10, the Second Affiliated Hospital of Heilongjiang University of Chinese Medicine, Harbin, China
| |
Collapse
|
3
|
Bianchi SP, Faccenda V, Pacifico P, Parma G, Saufi S, Ferrario F, Belmonte M, Sala L, De Ponti E, Panizza D, Arcangeli S. Short-term pain control after palliative radiotherapy for uncomplicated bone metastases: a prospective cohort study. Med Oncol 2023; 41:13. [PMID: 38079079 DOI: 10.1007/s12032-023-02238-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2023] [Accepted: 11/04/2023] [Indexed: 12/18/2023]
Abstract
This study aimed at evaluating the efficacy of different radiotherapy (RT) fractionation regimens in managing uncomplicated painful bone metastases (BM) and identifying predictive factors for pain control. Patients with 1 to 4 symptomatic BM from any primary solid tumors and a life expectancy exceeding 3 months were included in the study and received palliative RT, with SBRT restricted in the context of oligometastatic disease or in patients with good prognosis. Pain analysis using the Brief Pain Inventory (BPI) tool was conducted at baseline, 1 and 3 months after RT. Analgesic intake was recorded as morphine-equivalent doses (OME). Pain response was assessed using the International Consensus on Palliative Radiotherapy Endpoint (ICPRE). Multivariate logistic regression analyzed patient-related, tumor-related, and treatment-related factors predicting BM pain control at 3 months post-RT. From Feb 2022 to Feb 2023, 44 patients with 65 symptomatic BM were investigated. Breast (32%) and lung (24%) tumors were the most common primary tumors. Treatment plans included 3DCRT (60%) and VMAT (40%), with a median biological effective dose for tumors (BED) of 29 Gy [14-108]. All patients completed the 3-month follow-up. Pain response rates were 62% at 1 month and 60% at 3 months. Responders had better PS ECOG scores (67%; P = 0.008) and received active systemic therapies (67%: P = 0.036). Non-responders had lower pretreatment BPI (mean: 13.7 vs. 58.2; P = 0.032), with significantly higher values after 1 month (mean: 9.1 vs. 5.3, P = 0.033). Baseline BPI (OR: 1.17; 95% CI: 1.032-1.327; P = 0.014) and BPI at 1 month (OR: 0.83; 95% CI: 0.698-0.976; P = 0.025) were independent predictors of pain response at 3 months. Our findings show that palliative RT ensured short-term pain control in patients with BM, regardless of tumor type and dose-fractionation regimen. A larger sample size and a longer follow-up could potentially identify which patients are likely to benefit most from RT, and which fractionation might be indicated for achieving a durable pain relief. A multidisciplinary approach is paramount to provide a better care to BM patients.
Collapse
Affiliation(s)
- Sofia Paola Bianchi
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Valeria Faccenda
- Medical Physics Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Pietro Pacifico
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Gaia Parma
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Sara Saufi
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Federica Ferrario
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Maria Belmonte
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Luca Sala
- Clinical Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Elena De Ponti
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Medical Physics Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Denis Panizza
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy
- Medical Physics Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy
| | - Stefano Arcangeli
- School of Medicine and Surgery, University of Milano Bicocca, Milan, Italy.
- Radiation Oncology Department, Fondazione IRCCS San Gerardo Dei Tintori, Monza, Italy.
| |
Collapse
|
4
|
Macharia JM, Raposa BL, Sipos D, Melczer C, Toth Z, Káposztás Z. The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients. Healthcare (Basel) 2023; 11:2954. [PMID: 37998446 PMCID: PMC10671794 DOI: 10.3390/healthcare11222954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 11/10/2023] [Accepted: 11/10/2023] [Indexed: 11/25/2023] Open
Abstract
Pain continues to be a significant problem for cancer patients, and the impact of a population-based strategy on their experiences is not completely understood. Our study aimed to determine the impact of palliative care on mitigating pain and its associated effects in determining the quality of life (QoL) among colon cancer outpatients. Six collection databases were used to perform a structured systematic review of the available literature, considering all papers published between the year 2000 and February 2023. PRISMA guidelines were adopted in our study, and a total of 9792 papers were evaluated. However, only 126 articles met the inclusion criteria. A precise diagnosis of disruptive colorectal cancer (CRC) pain disorders among patients under palliative care is necessary to mitigate it and its associated effects, enhance health, promote life expectancy, increase therapeutic responsiveness, and decrease comorbidity complications. Physical activities, the use of validated pain assessment tools, remote outpatient education and monitoring, chemotherapeutic pain reduction strategies, music and massage therapies, and bridging social isolation gaps are essential in enhancing QoL. We recommend and place a strong emphasis on the adoption of online training/or coaching programs and the integration of formal and informal palliative care systems for maximum QoL benefits among CRC outpatients.
Collapse
Affiliation(s)
- John M. Macharia
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Bence L. Raposa
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Dávid Sipos
- Department of Medical Imaging, Faculty of Health Sciences, University of Pécs, Szent Imre Str 14/B, 7400 Kaposvár, Hungary
| | - Csaba Melczer
- Institute of Physiotherapy and Sport Science, Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary;
| | - Zoltan Toth
- Doctoral School of Health Sciences, Faculty of Health Science, University of Pẻcs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| | - Zsolt Káposztás
- Faculty of Health Sciences, University of Pécs, Vörösmarty Str 4, 7621 Pẻcs, Hungary
| |
Collapse
|
5
|
McNally GA, McLaughlin EM, Ridgway-Limle E, Rosselet R, Baiocchi R. Opioid Risk Mitigation Practices of Interprofessional Oncology Personnel: Results From a Cross-Sectional Survey. Oncologist 2023; 28:996-1004. [PMID: 37498515 PMCID: PMC10628582 DOI: 10.1093/oncolo/oyad214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Accepted: 07/06/2023] [Indexed: 07/28/2023] Open
Abstract
BACKGROUND This study explored the risk mitigation practices of multidisciplinary oncology health-care personnel for the nonmedical use of opioids in people with cancer. METHODS An anonymous, cross-sectional descriptive survey was administered via email to eligible providers over 4 weeks at The Ohio State University's Arthur G. James Cancer Hospital. The survey asked about experiences and knowledge related to opioid use disorders. RESULTS The final sample of 773 participants included 42 physicians, 213 advanced practice providers (APPs consisted of advanced practice nurses, physician assistants, and pharmacists), and 518 registered nurses. Approximately 40% of participants responded feeling "not confident" in addressing medication diversion. The most frequent risk reduction measure was "Checking the prescription drug monitoring program" when prescribing controlled medications, reported by physicians (n = 29, 78.4%) and APPs (n = 164, 88.6%). CONCLUSION People with cancer are not exempt from the opioid epidemic and may be at risk for nonmedical opioid use (NMOU) and substance use disorders. Implementing risk reduction strategies with every patient, with a harm reduction versus abstinence focus, minimizes harmful consequences and improves. This study highlights risk mitigation approaches for NMOU, representing an opportunity to improve awareness among oncology health-care providers. Multidisciplinary oncology teams are ideally positioned to navigate patients through complex oncology and health-care journeys.
Collapse
Affiliation(s)
- Gretchen A McNally
- Department of Nursing, James Cancer Hospital, The Ohio State University, Columbus, OH, USA
| | - Eric M McLaughlin
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - Emily Ridgway-Limle
- Department of Nursing, James Cancer Hospital, The Ohio State University, Columbus, OH, USA
| | - Robin Rosselet
- College of Nursing, The Ohio State University, Columbus, OH, USA
| | - Robert Baiocchi
- Division of Hematology, College of Medicine, The Ohio State University, Columbus, OH, USA
| |
Collapse
|
6
|
Zheng G, Ren J, Shang L, Bao Y. Role of autophagy in the pathogenesis and regulation of pain. Eur J Pharmacol 2023; 955:175859. [PMID: 37429517 DOI: 10.1016/j.ejphar.2023.175859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2023] [Revised: 06/08/2023] [Accepted: 06/15/2023] [Indexed: 07/12/2023]
Abstract
Pain is a ubiquitous and highly concerned clinical symptom, usually caused by peripheral or central nervous injury, tissue damage, or other diseases. The long-term existence of pain can seriously affect daily physical function and quality of life and produce great torture on the physiological and psychological levels. However, the complex pathogenesis of pain involving molecular mechanisms and signaling pathways has not been fully elucidated, and managing pain remains highly challenging. As a result, finding new targets to pursue effective and long-term pain treatment strategies is required and urgent. Autophagy is an intracellular degradation and recycling process that maintains tissue homeostasis and energy supply, which can be cytoprotective and is vital in maintaining neural plasticity and proper nervous system function. Much evidence has shown that autophagy dysregulation is linked to the emergence of neuropathic pain, such as postherpetic neuralgia and cancer-related pain. Autophagy has also been connected to pain caused by osteoarthritis and lumbar disc degeneration. It is worth noting that in recent years, studies on traditional Chinese medicine have also proved that several traditional Chinese medicine monomers involve autophagy in the mechanism of pain relief. Therefore, autophagy can serve as a potential regulatory target to provide new ideas and inspiration for pain management.
Collapse
Affiliation(s)
- Guangda Zheng
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| | - Juanxia Ren
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning Province, China.
| | - Lu Shang
- Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, Liaoning Province, China.
| | - Yanju Bao
- Department of Oncology, Guang'anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China.
| |
Collapse
|
7
|
Cascella M, Petrucci E, Marinangeli F, Vittori A. "Emerging Topics in Pain Medicine": Advancing Research and Patient-Centered Health Strategies. J Pers Med 2023; 13:1246. [PMID: 37623495 PMCID: PMC10455183 DOI: 10.3390/jpm13081246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 08/08/2023] [Indexed: 08/26/2023] Open
Abstract
Pain, in all its various forms and manifestations, impacts the lives of millions worldwide [...].
Collapse
Affiliation(s)
- Marco Cascella
- Division of Anesthesia and Pain Medicine, Istituto Nazionale Tumori, IRCCS, “Fondazione G. Pascale”, 80131 Naples, Italy
| | - Emiliano Petrucci
- Department of Anesthesia and Intensive Care Unit, San Salvatore Academic Hospital of L’Aquila, 67100 L’Aquila, Italy
| | - Franco Marinangeli
- Department of Anesthesiology, Intensive Care and Pain Treatment, University of L’Aquila, Piazzale Salvatore Tommasi 1, 67100 Coppito, Italy
| | - Alessandro Vittori
- Department of Anesthesia and Critical Care, ARCO ROMA, Ospedale Pediatrico Bambino Gesù IRCCS, Piazza S. Onofrio 4, 00165 Rome, Italy
| |
Collapse
|
8
|
Ortiz YT, Bilbrey JA, Felix JS, Kienegger EA, Mottinelli M, Mukhopadhyay S, McCurdy CR, McMahon LR, Wilkerson JL. Cannabidiol and mitragynine exhibit differential interactive effects in the attenuation of paclitaxel-induced mechanical allodynia, acute antinociception, and schedule-controlled responding in mice. Pharmacol Rep 2023; 75:937-950. [PMID: 37243887 DOI: 10.1007/s43440-023-00498-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 05/12/2023] [Accepted: 05/15/2023] [Indexed: 05/29/2023]
Abstract
BACKGROUND For many chemotherapy patients peripheral neuropathy is a debilitating side effect. Mitragyna speciosa (kratom) contains the alkaloid mitragynine (MG), which produces analgesia in multiple preclinical pain models. In humans, anecdotal reports suggest cannabidiol (CBD) may enhance kratom-related analgesia. We examined the interactive activity of MG and CBD in a mouse chemotherapy-induced peripheral neuropathy (CIPN) model. We also examined MG + CBD in acute antinociception and schedule-controlled responding assays, as well as examined underlying receptor mechanisms. METHODS Male and female C57BL/6J mice received a cycle of intraperitoneal (ip) paclitaxel injections (cumulative dose 32 mg/kg). The von Frey assay was utilized to assess CIPN allodynia. In paclitaxel-naïve mice, schedule-controlled responding for food was conducted under a fixed ratio (FR)-10, and hot plate antinociception was examined. RESULTS MG dose-relatedly attenuated CIPN allodynia (ED50 102.96 mg/kg, ip), reduced schedule-controlled responding (ED50 46.04 mg/kg, ip), and produced antinociception (ED50 68.83 mg/kg, ip). CBD attenuated allodynia (ED50 85.14 mg/kg, ip) but did not decrease schedule-controlled responding or produce antinociception. Isobolographic analysis revealed 1:1, 3:1 MG + CBD mixture ratios additively attenuated CIPN allodynia. All combinations decreased schedule-controlled responding and produced antinociception. WAY-100635 (serotonin 5-HT1A receptor antagonist) pretreatment (0.01 mg/kg, ip) antagonized CBD anti-allodynia. Naltrexone (pan opioid receptor antagonist) pretreatment (0.032 mg/kg, ip) antagonized MG anti-allodynia and acute antinociception but produced no change in MG-induced decreased schedule-controlled behavior. Yohimbine (α2 receptor antagonist) pretreatment (3.2 mg/kg, ip) antagonized MG anti-allodynia and produced no change in MG-induced acute antinociception or decreased schedule-controlled behavior. CONCLUSIONS Although more optimization is needed, these data suggest CBD combined with MG may be useful as a novel CIPN therapeutic.
Collapse
Affiliation(s)
- Yuma T Ortiz
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA
| | - Joshua A Bilbrey
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Jasmine S Felix
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Erik A Kienegger
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Marco Mottinelli
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Chemistry and Chemical Biology, College of Science, Northeastern University, Boston, MA, USA
| | - Sushobhan Mukhopadhyay
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Christopher R McCurdy
- Department of Medicinal Chemistry, College of Pharmacy, University of Florida, Gainesville, FL, USA
| | - Lance R McMahon
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA
| | - Jenny L Wilkerson
- Department of Pharmacodynamics, College of Pharmacy, University of Florida, Gainesville, FL, USA.
- Department of Pharmaceutical Sciences, Jerry H. Hodge School of Pharmacy, Texas Tech University Health Sciences Center, 1406 S. Coulter., Amarillo, TX, 79106, USA.
| |
Collapse
|
9
|
McLarney M, Johnson T, Bajaj G, Lee D, Zheng J. Cancer Pain and Frailty: A Scoping Review of How Cancer Pain Is Evaluated and Treated in the Frail and Elderly. REHABILITATION ONCOLOGY 2023. [DOI: 10.1097/01.reo.0000000000000338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/31/2023]
|
10
|
Tuan J, Wang EH, De Leon JRC, Mendoza MJ, Varrassi G. Management of Acute Cancer Pain in Asia: An Expert Opinion on the Role of Tramadol/Dexketoprofen Fixed-Dose Combination. Cureus 2023; 15:e35770. [PMID: 37025730 PMCID: PMC10072166 DOI: 10.7759/cureus.35770] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/04/2023] [Indexed: 03/07/2023] Open
Abstract
Most patients experience acute cancer pain at some stage throughout their cancer journey. When inadequately managed, cancer pain has devastating consequences for the patient's quality of life. The suboptimal management of cancer pain in Asia is mainly driven by over-regulation and limited access to opioids. Concerns about adverse events and addiction have resulted in a negative perception of this group of drugs among physicians, as well as patients. There is a need to optimize the management of cancer pain across the region, through the provision of an alternative treatment option that is simple to prescribe, convenient to administer and well tolerated by patients, which will increase patients' compliance and good results. As recommended in many international guidelines, starting by the WHO analgesic ladder, cancer pain can be effectively managed with multimodal analgesia. Fixed-dose combinations (FDCs), in which two or more analgesic agents act synergistically to deliver a broad spectrum of pain relief, represent an effective and convenient option for delivering multimodal analgesia to patients with cancer pain. This is extremely well accepted by patients for several reasons. Any multimodal pharmacological approach to pain management should be based on the potentiality to block pain at different levels and to reduce the dosages of single analgesics, reducing their side effects. Hence, the use of NSAIDs, combined with other analgesics, is the general basis of multimodal pain management. If NSAIDs are combined with tramadol, a weak opioid that has per se a multimodal analgesic efficacy, it may be ideal. The tramadol/dexketoprofen FDC combines the centrally acting weak opioid with a peripherally acting NSAID to deliver rapid-onset, long-lasting analgesia, which has been proven efficacious and safe in the management of moderate-to-severe acute pain in the postoperative setting. This expert opinion explores the role of tramadol/dexketoprofen FDC in the management of patients with moderate-to-severe acute cancer pain. It is essentially based on the incredibly high amount of existing data on the use of the drug, and on the long-lasting experience of the experts in pain management of cancer patients participating in the advisory panel.
Collapse
|
11
|
The Impact of Bevacizumab and Chemotherapy on Quality of Life in Metastatic Colorectal Cancer Patients. Healthcare (Basel) 2023; 11:healthcare11040591. [PMID: 36833125 PMCID: PMC9956224 DOI: 10.3390/healthcare11040591] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Revised: 02/13/2023] [Accepted: 02/15/2023] [Indexed: 02/18/2023] Open
Abstract
Health-related quality is of life of great importance in cancer care. This prospective study aimed to evaluate the impact of chemotherapy and bevacizumab on the activities of daily living, cancer symptoms, and general well-being in 59 metastatic colorectal cancer patients. We gathered information using the EORTC QLQ-C30 and QLQ-CR29 questionnaires. The paired sample t-test, MANOVA test, and Pearson's correlation test were used to analyze the presence of significant differences in mean scores before and after 6 months of treatment. The results revealed significant differences in the functioning and symptoms that influence patients' quality of life after 6 months of treatment: increased pain (p = 0.003), nausea and vomiting (p = 0.003), diarrhea (p = 0.021) and decreased appetite (p = 0.003). At the same time, there were several aspects that improved the quality of life. Increases in emotional function (p = 0.009), cognitive function (p = 0.033), and perception of body image (p = 0.026) were observed after 6 months of treatment. Elderly patients reported a higher frequency of stools (p = 0.028), and young patients had increased concerns about body perception (p = 0.047). Assessing the quality of life of metastatic colorectal cancer patients is an important way to identify and treat symptoms related to both cancer and therapy by establishing a holistic care plan and implementing measures to increase the quality of life.
Collapse
|
12
|
Wu Y, Wang N, Zhang H, Sun X, Wang Y, Zhang Y. Effectiveness of Virtual Reality in Symptom Management of Cancer Patients: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2023; 65:e467-e482. [PMID: 36758907 DOI: 10.1016/j.jpainsymman.2023.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 01/19/2023] [Accepted: 01/24/2023] [Indexed: 02/10/2023]
Abstract
CONTEXT Although the survival rate of cancer patients has been increasing, such patients often experience severe physical and psychological burdens due to the effects of the disease and therapy. Multiple virtual reality (VR)-based interventions have been used to help improve physical and psychological symptoms and quality of life in cancer patients. OBJECTIVE This study aimed to assess the effects of VR-based interventions on anxiety, pain, depression, fear, distress, and quality of life in cancer patients. METHODS We conducted systematic searches in the PubMed, Web of Science, CINAHL, EMBASE, Cochrane Library, Scopus and APA PsycINFO databases from their inception to August 16, 2022. Two reviewers independently selected studies and extracted articles that met strict inclusion and exclusion criteria. Quality assessments of the included studies were performed according to the Cochrane risk assessment tool, and data analysis was performed using RevMan 5.4 software. RESULTS A total of 12 studies including 425 participants in the intervention group and 400 participants in the control group were selected for the final analysis. The results showed a significant difference between the VR and control groups for anxiety (standard mean difference [SMD] =-0.83, 95% CI -1.25 to -0.42, P < 0.001), SMD = pain (SMD =-0.86, 95% CI -1.36 to -0.35, P < 0.001), depression (SMD = -0.46, 95% CI -0.74 to -0.18, P = 0.001), fear (MD = -0.82, 95% CI -1.60 to -0.03, P = 0.04), and distress (SMD = -1.16, 95% CI -1.96 to -0.37, P = 0.004). However, no significant difference was observed in quality of life (SMD = 1.01, 95% CI -0.67 to 2.70, P = 0.24). CONCLUSIONS VR interventions were effective in improving physical and psychological symptoms in cancer patients. Due to the limited number of studies, small sample sizes, and moderate to high heterogeneity, these results should be interpreted with caution. More rigorous, comprehensive and high-quality randomized controlled trials (RCTs) are needed to validate the results of this study. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022304931;https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=304931.
Collapse
Affiliation(s)
- Yuan Wu
- School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China
| | - Nannan Wang
- School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China
| | - Huichao Zhang
- School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China
| | - Xuhan Sun
- School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China
| | - Yuqing Wang
- School of Nursing, Nanjing University of Chinese Medicine (Y.W., N.W., H.Z., X.S., Y.W.), Nanjing, Jiangsu, China
| | - Yuxi Zhang
- Geriatric Hematology/Radiotherapy Ward, the First Affiliated Hospital of Nanjing Medical University (Y.Z.), 300 Guangzhou Road, Nanjing, Jiangsu, China.
| |
Collapse
|
13
|
Zhou S, Jin Q, Yao H, Ying J, Tian L, Jiang X, Yang Y, Jiang X, Gao W, Zhang W, Zhu Y, Cao W. Pain-Related Gene Solute Carrier Family 24 Member 3 Is a Prognostic Biomarker and Correlated with Immune Infiltrates in Cervical Squamous Cell Carcinoma and Endocervical Adenocarcinoma: A Study via Integrated Bioinformatics Analyses and Experimental Verification. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2023; 2023:4164232. [PMID: 36798148 PMCID: PMC9928512 DOI: 10.1155/2023/4164232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 10/13/2022] [Accepted: 11/24/2022] [Indexed: 02/10/2023]
Abstract
The aim of this study was to explore cervical carcinoma and screen a suitable gene as the biomarker used for prognosis evaluation as well as pain therapy. Low expression levels of solute carrier family 24 member 3 (SLC24A3) was involved in the appearance and development of numerous malignancies. Nevertheless, the prognostic value of SLC24A3 expression with cervical squamous cell carcinoma and endocervical adenocarcinoma (CESC) patients remains uncertain. During the present study, SLC24A3 expression in CESC was retrieved from TCGA, GEO, and MSigDB databases. Based on TCGA and GEO profiles, we performed survival and difference analyses about SLC24A3 both in two GEO (GSE44001 and GSE63514) and TCGA-CESC cohorts (all p < 0.05), indicating that SLC24A3 was low expressed in tumors and associated with higher overall survival in CESC patients. Additionally, we programmed a series of analyses, including genomic profiling, enrichment analysis, immune infiltration analysis, and therapy-related analysis to identify the mechanism of the SLC24A3 in the process of cancer in CESC. Meanwhile, qRT-PCR was used to validate that the expression of SLC24A3 mRNA in Hela and SiHa cell lines was significantly lower than in PANC-1 and HUCEC cell lines. Our finding elucidated that the SLC24A3, a sodium-calcium regulator of cells, is an indispensable factor which can significantly influence the prognosis of patients with CESC and could provide novel clinical evidence to serve as a potential biological indicator for future diagnosis and pain therapy.
Collapse
Affiliation(s)
- Shuguang Zhou
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Linquan Maternity and Child Healthcare Hospital, Fuyang, Anhui 236400, China
| | - Qinqin Jin
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Hui Yao
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Jie Ying
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Lu Tian
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Xiya Jiang
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Yinting Yang
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Xiaomin Jiang
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Wei Gao
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Weiyu Zhang
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Yuting Zhu
- Department of Gynecology, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
- Department of Gynecology, Anhui Medical University Affiliated Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| | - Wujun Cao
- Department of Clinical Laboratory, Anhui Province Maternity and Child Healthcare Hospital, Hefei, Anhui 230001, China
| |
Collapse
|
14
|
Su X, Wang B, Zhou Z, Li Z, Tong S, Chen S, Zhang N, Liu S, Zhang M. A positive feedback loop of heparanase/syndecan1/nerve growth factor regulates cancer pain progression. Korean J Pain 2023; 36:60-71. [PMID: 36536517 PMCID: PMC9812689 DOI: 10.3344/kjp.22277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 10/21/2022] [Accepted: 10/22/2022] [Indexed: 12/24/2022] Open
Abstract
Background The purpose of this research was to assess the role of heparanase (HPSE)/syndecan1 (SDC1)/nerve growth factor (NGF) on cancer pain from melanoma. Methods The influence of HPSE on the biological function of melanoma cells and cancer pain in a mouse model was evaluated. Immunohistochemical staining was used to analyze HPSE and SDC1. HPSE, NGF, and SDC1 were detected using western blot. Inflammatory factors were detected using ELISA assay. Results HPSE promoted melanoma cell viability, proliferation, migration, invasion, and tumor growth, as well as cancer pain, while SST0001 treatment reversed the promoting effect of HPSE. HPSE up-regulated NGF, and NGF feedback promoted HPSE. High expression of NGF reversed the inhibitory effect of HPSE down-regulation on melanoma cell phenotype deterioration, including cell viability, proliferation, migration, and invasion. SST0001 down-regulated SDC1 expression. SDC1 reversed the inhibitory effect of SST0001 on cancer pain. Conclusions The results showed that HPSE promoted melanoma development and cancer pain by interacting with NGF/SDC1. It provides new insights to better understand the role of HPSE in melanoma and also provides a new direction for cancer pain treatment.
Collapse
Affiliation(s)
- Xiaohu Su
- Department of Anesthesiology, Suqian First People’s Hospital, Suqian City, Jiangsu Province, China
| | - Bingwu Wang
- Cancer Institute, The Second Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Zhaoyun Zhou
- Department of Anesthesiology, Tai’an Central Hospital, Tai’an City, Shandong Province, China
| | - Zixian Li
- Department of Anesthesiology, Graduate School of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Song Tong
- Department of Anesthesiology, Graduate School of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Simin Chen
- Department of Anesthesiology, Graduate School of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Nan Zhang
- Department of Anesthesiology, Graduate School of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Su Liu
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China
| | - Maoyin Zhang
- Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou City, Jiangsu Province, China,Correspondence: Maoyin Zhang Department of Anesthesiology, The Affiliated Hospital of Xuzhou Medical University, No. 99, Huaihai West Road, Quanshan District, Xuzhou City, Jiangsu Province 221002, China, Tel: +86-18168777315, Fax: +86-0516-85805911, E-mail:
| |
Collapse
|
15
|
Li C, Zhao C, Zhao J, Wang M, Luo F, Zhou J. Global research trends of acupuncture therapy on cancer pain: A bibliometric and visualized study. Front Oncol 2023; 13:1077961. [PMID: 36950556 PMCID: PMC10026736 DOI: 10.3389/fonc.2023.1077961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 02/10/2023] [Indexed: 03/08/2023] Open
Abstract
Background The number of publications on acupuncture for cancer pain is increasing rapidly with an upward tendency. Considering that no bibliometric articles related to this topic have been published yet. It is necessary to evaluate the global scientific output of research in this field, and shed light on the direction of clinical cancer pain management in the future. Methods Research publications regarding acupuncture on cancer pain from inception to 2022 were downloaded from the Web of Science Core Collection. Bibliometric analyses were performed using CiteSpace software, the bibliometrix R package, and VOSviewer software. Network maps were generated to assess the collaborations between different countries, institutions, authors, and keywords. And clusters map was generated to evaluate reference. Results A total of 790 articles related to acupuncture therapy for cancer pain were identified. We observe that the number of publications is gradually increasing over time. China and the United States were the main contributors. Mem Sloan Kettering Canc Ctr (38 papers) and Beijing Univ Chinese Med (28 papers) contributed the most publications, becoming the leading contributors in this field. Although J Clin Oncol (28 articles) ranked ninth in terms of publication volume, it was the journal with the most citations and the highest number of IF (50.717) and H-index (494) at the same time. MAO J from Mem Sloan Kettering Canc Ctr was the most prolific author (23 articles). The main hot topics included matters related to acupuncture (239 times), pain (199 times), management (139 times), quality of life (107 times), electroacupuncture (100 times), and breast cancer (82 times). Conclusion Our bibliometric analysis provides a comprehensive overview of the development of acupuncture for cancer pain, enabling relevant authors and research teams to identify the current research status in this field. At the same time, acupuncture for breast cancer (BC) pain, aromatase inhibitor-induced arthralgia (AIA), and chemotherapy-induced peripheral neuropathy (CIPN) may soon become prospective focus.
Collapse
Affiliation(s)
- Chunyu Li
- Acupuncture and Tuina School/The 3rd Teaching Hospital, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Can Zhao
- College of Pharmacy, Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Jingjing Zhao
- Department of Acupuncture, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Min Wang
- Department of Acupuncture, Sichuan Second Hospital of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Furong Luo
- Department of Traditional Chinese Medicine, Xi’an No. 3 Hospital, the Affiliated Hospital of Northwest University, Xi’an, Shanxi, China
| | - Jianwei Zhou
- Sichuan Academy of Chinese Medicine Sciences, Chengdu, Sichuan, China
- *Correspondence: Jianwei Zhou,
| |
Collapse
|
16
|
β-Elemene Improves Morphine Tolerance in Bone Cancer Pain via N-Methyl-D-Aspartate Receptor 2B Subunit-Mediated μ-Opioid Receptor. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:9897669. [PMID: 36164617 PMCID: PMC9509249 DOI: 10.1155/2022/9897669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/07/2022] [Accepted: 09/08/2022] [Indexed: 11/17/2022]
Abstract
Background Improving morphine tolerance (MT) is an urgent problem in the clinical treatment of bone cancer pain. Considering that β-Elemene is widely used in the treatment of cancer pain, we explored the effects and mechanism of β-Elemene in preventing MT of bone cancer pain. Method Bone cancer pain and chronic MT rat model was established by injecting MADB106 cells and morphine (10 mg/kg). SH-SY5Y cells were treated with morphine (10 μg/mL) for 48 h to establish a cell model. The mechanical withdrawal threshold and thermal withdrawal latency of rats were detected by mechanical allodynia and thermal hyperalgesia tests, respectively. The protein expressions of μ-opioid receptor (MOPR), cyclic adenosine monophosphate (cAMP), N-methyl-D-aspartate receptor subunit 2B (NR2B), phosphorylated-calmodulin-dependent protein kinase II (p-CaMKII), and CaMKII were detected by western blot. The viability of SH-SY5Y cells was determined by the cell counting kit-8 assay. cAMP content in SH-SY5Y cells was measured by a LANCE cAMP kit. Result Animal experiments showed that MT strengthened over time, while increased β-Elemene dosage alleviated MT. The viability of SH-SY5Y cells was down-regulated by high-dose β-Elemene. In the rat and cell models, long-term morphine treatment decreased the expression of MOPR and increased the cAMP and NR2B expressions and p-CaMKII/CaMKII, while β-Elemene and siNR2B counteracted the effects of morphine treatment. In addition, siNR2B reversed the effects of β-Elemene on related protein expressions and cAMP content in the cell model. Conclusion β-Elemene improved MT in bone cancer pain through the regulation of NR2B-mediated MOPR.
Collapse
|
17
|
Yang S, Tan W, Ma X, Qi L, Wang X. Worldwide Productivity and Research Trend of Publications Concerning Cancer-Related Neuropathic Pain: A Bibliometric Study. J Pain Res 2022; 15:2747-2759. [PMID: 36106314 PMCID: PMC9467449 DOI: 10.2147/jpr.s378119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Accepted: 09/01/2022] [Indexed: 12/01/2022] Open
Abstract
Cancer-related neuropathic pain is a common adverse effect in the process of cancer development and treatment and has gradually attracted the attention of researchers. The purpose of this article is to systematically review the articles on cancer-related neuropathic pain published between 2012 and 2021 and visualize the data through CiteSpace and R software. The results show that in the past 10 years, a total of 5715 articles have been published, involving 118 categories, of which the most is Clinical Neurology, followed by Neurosciences, Pharmacology Pharmacy. The country with the most published articles is the United States, followed by China and Italy. A total of 22,228 authors were involved in the study of cancer-related neuropathic pain. These historical opinions about cancer-related neuropathic pain could be an important practical basis for further research into potential development trends.
Collapse
Affiliation(s)
- Shengjie Yang
- Phase I Clinical Trial Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Weijuan Tan
- Phase I Clinical Trial Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Xiao Ma
- Department of Surgery Medicine, Zhangqiu People's Hospital, Jinan, 250200, People's Republic of China
| | - Lu Qi
- Phase I Clinical Trial Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| | - Xinghe Wang
- Phase I Clinical Trial Center, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, People's Republic of China
| |
Collapse
|
18
|
Bovero A, Digiovanni Y, Botto R, Leombruni P. End-of-life cancer patients' total pain: the necessity to supplement pharmacology with psycho-socio-spiritual treatments. Pain Manag 2022; 12:895-906. [PMID: 36065852 DOI: 10.2217/pmt-2022-0015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To analyze pain considering its different bio-psycho-social-spiritual manifestations and to assess the effectiveness of the analgesic treatments in end-of-life cancer patients. Materials & methods: The study was cross-sectional. A total of 376 end-of-life cancer inpatients participated in the research. Their socio-demographic and clinical data were collected and, during the first psychological consultancy, they filled in a set of validated rating scales assessing pain, anxiety, depression and quality of life. Results: The results show that physical pain was well managed for almost all patients. Nevertheless, the majority showed clinically significant levels of psychological distress. Conclusion: Treating pain means caring for all its possible manifestations including psychological symptoms and reduced wellbeing. Thus, integrating pharmacological treatment with psycho-socio-spiritual interventions, in other words, psychological, social and spiritual support, could be effective and desirable.
Collapse
Affiliation(s)
- Andrea Bovero
- Clinical Psychology Unit, Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Ylenia Digiovanni
- Clinical Psychology Unit, Hospital 'Città della Salute e della Scienza', Turin, Italy
| | - Rossana Botto
- Clinical Psychology Unit, Hospital 'Città della Salute e della Scienza', Turin, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
| | - Paolo Leombruni
- Clinical Psychology Unit, Hospital 'Città della Salute e della Scienza', Turin, Italy.,Department of Neuroscience, University of Turin, Turin, Italy
| |
Collapse
|
19
|
Stoorvogel H, van Haastregt J, Theunissen M, Schoenmaekers J, Hoeben A, van den Beuken-van Everdingen M. Unacceptable pain in oncology: The patients' perspective on reasons for absence of pain interventions. Eur J Cancer Care (Engl) 2022; 31:e13628. [PMID: 35662290 PMCID: PMC9541915 DOI: 10.1111/ecc.13628] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 04/29/2022] [Accepted: 05/16/2022] [Indexed: 11/05/2022]
Abstract
Objective Around 40% of oncology patients receive inadequate pain treatment. A previous study reported pain interventions for only 70% of patients who reported unacceptable pain at the self‐service registration desk. The aim of this study is to gain insight in reasons for the absence of pain intervention among oncology patients who reported unacceptable pain. Methods In this mixed methods study, 20 patients visiting the oncology outpatient clinic were selected via patient record assessment and interviewed about their perceived reasons for absence of pain intervention. Results The reasons mentioned by the patients for absence of pain intervention included reluctance of the patient to discuss pain, no treatment preferred by the patient, focus of the physician on treatment of the disease, pain treatment difficult or impossible, and the perception that pain is an inevitable consequence of the cancer treatment. Almost 50% of the patients considered the physician responsible for the absence of pain intervention. Conclusion In conclusion, a variety of reasons for absence of pain intervention are reported by patients, including patient‐related and health professional‐related reasons. Improvements can be made by promoting regular discussion of pain during hospital visits and empowerment of patients.
Collapse
Affiliation(s)
- Hester Stoorvogel
- Department of Internal Medicine, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Department of IQ Healthcare, Radboud Institute for Health Sciences, Radboud University Medical Center, Nijmegen, The Netherlands.,Centre of Expertise for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Jolanda van Haastregt
- Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.,Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Maurice Theunissen
- Centre of Expertise for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Janna Schoenmaekers
- Centre of Expertise for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Pulmonary Diseases, GROW-School for Oncology and Developmental Biology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Ann Hoeben
- Centre of Expertise for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Medical Oncology, GROW-School for Oncology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Marieke van den Beuken-van Everdingen
- Centre of Expertise for Palliative Care, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Anesthesiology and Pain Management, Maastricht University Medical Center+, Maastricht, The Netherlands
| |
Collapse
|
20
|
Ruano A, García-Torres F, Gálvez-Lara M, Moriana JA. Psychological and Non-Pharmacologic Treatments for Pain in Cancer Patients: A Systematic Review and Meta-Analysis. J Pain Symptom Manage 2022; 63:e505-e520. [PMID: 34952171 DOI: 10.1016/j.jpainsymman.2021.12.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/07/2021] [Accepted: 12/11/2021] [Indexed: 12/21/2022]
Abstract
CONTEXT Pain is the most fearful symptom in cancer. Although there is a relationship between psychosocial variables and oncologic pain, psychological and non-pharmacological treatments for pain management in cancer patients are not very widespread. OBJECTIVES To analyze the efficacy of psychological and non-pharmacological treatments for reducing pain in cancer patients. METHODS We performed a systematic review following the PRISMA protocol. In January 2021, data were extracted from PubMed, Web of Science and Scopus, including randomised controlled trials (RCT) published in the last five years (from 28 January, 2015 to December 15, 2020), in the English language and whose sample was patients with cancer pain. The database search used the following keywords: cancer, cancer-related pain, psychological intervention, non-pharmacologic intervention. The Cochrane risk of bias assess ment for randomised trials (RoB 2) was used for quality appraisal. RESULTS After the inclusion and exclusion criteria were applied, ten papers were fully screened. The evidence suggested that the most effective interventions to reduce cancer pain were mindfulness-based cognitive therapy, guided imagery and progressive muscle relaxation and emotional and symptom focused engagement (EASE). Music therapy and brief cognitive behavioral strategies (CBS) require more research, while coping skills training and yoga did not show positive effects. Overall, we obtained a moderate size effect (d = 0.642, 95% CI: 0.125-1.158) favourable to psychological and non-pharmacologic treatments at post-treatment, which increased at follow-up (k = 5, d = 0.826, 95% CI: 0.141-1.511). CONCLUSION This study provides insight into psychological interventions which might be applied and contribute to cancer-related pain reduction in adults. Although the results are not completely consistent, they may shed light on psychology applications in the oncology environment.
Collapse
Affiliation(s)
- Alejandra Ruano
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
| | - Francisco García-Torres
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain.
| | - Mario Gálvez-Lara
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
| | - Juan A Moriana
- Department of Psychology, University of Cordoba (A.R., F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Maimonides Institute for Research in Biomedicine of Cordoba (IMIBIC) (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain; Reina Sofia University Hospital (F.G.-T., M.G.-L., J.A.M.), Cordoba, Spain
| |
Collapse
|
21
|
Moscato S, Cortelli P, Chiari L. Physiological responses to pain in cancer patients: A systematic review. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2022; 217:106682. [PMID: 35172252 DOI: 10.1016/j.cmpb.2022.106682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 01/23/2022] [Accepted: 02/04/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND AND OBJECTIVE Pain is one of the most debilitating symptoms in persons with cancer. Still, its assessment is often neglected both by patients and healthcare professionals. There is increasing interest in conducting pain assessment and monitoring via physiological signals that promise to overcome the limitations of state-of-the-art pain assessment tools. This systematic review aims to evaluate existing experimental studies to identify the most promising methods and results for objectively quantifying cancer patients' pain experience. METHODS Four electronic databases (Pubmed, Compendex, Scopus, Web of Science) were systematically searched for articles published up to October 2020. RESULTS Fourteen studies (528 participants) were included in the review. The selected studies analyzed seven physiological signals. Blood pressure and ECG were the most used signals. Sixteen physiological parameters showed significant changes in association with pain. The studies were fairly consistent in stating that heart rate, the low-frequency to high-frequency component ratio (LF/HF), and systolic blood pressure positively correlate with the pain. CONCLUSIONS Current evidence supports the hypothesis that physiological signals can help objectively quantify, at least in part, cancer patients' pain experience. While there is much more to be done to obtain a reliable pain assessment method, this review takes an essential first step by highlighting issues that should be taken into account in future research: use of a wearable device for pervasive recording in a real-world context, implementation of a big-data approach possibly supported by AI, including multiple stratification factors (e.g., cancer site and stage, source of pain, demographic and psychosocial data), and better-defined recording procedures. Improved methods and algorithms could then become valuable add-ons in taking charge of cancer patients.
Collapse
Affiliation(s)
- Serena Moscato
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy.
| | - Pietro Cortelli
- IRCCS Istituto Delle Scienze Neurologiche Di Bologna, UOC Clinica Neurologica NeuroMet, Ospedale Bellaria, Bologna, Italy; Department of Biomedical and Neuromotor Sciences (DIBINEM), University of Bologna, Bologna, Italy
| | - Lorenzo Chiari
- Department of Electrical, Electronic, and Information Engineering "Guglielmo Marconi" - DEI, University of Bologna, Bologna, Italy; Health Sciences and Technologies, Interdepartmental Center for Industrial Research (CIRI-SDV), University of Bologna, Bologna, Italy
| |
Collapse
|
22
|
Lopez-Garzon M, Postigo-Martin P, González-Santos Á, Arroyo-Morales M, Achalandabaso-Ochoa A, Férnández-Pérez AM, Cantarero-Villanueva I. Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls. Support Care Cancer 2022; 30:3573-3584. [PMID: 35028719 PMCID: PMC8857146 DOI: 10.1007/s00520-022-06803-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Accepted: 12/31/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. METHODS An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal-Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen's d and Hedge's effect size, as appropriate. RESULTS The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). CONCLUSION Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.
Collapse
Affiliation(s)
- Maria Lopez-Garzon
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain
| | - Paula Postigo-Martin
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain. .,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain. .,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.
| | - Ángela González-Santos
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain
| | - Manuel Arroyo-Morales
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
| | | | | | - Irene Cantarero-Villanueva
- 'Cuídate' From Biomedical Group (BIO277), Instituto de Investigación Biosanitaria Ibs, University of Granada, Granada, Spain.,Department of Physiotherapy, Faculty of Health Sciences, University of Granada, Granada, Spain.,Instituto de Investigación Biosanitaria Ibs, GRANADA, Granada, Spain.,Unit of Excellence On Exercise and Health (UCEES), University of Granada, Granada, Spain
| |
Collapse
|
23
|
Sica A, Cittadini A, Bellantonio D, Russo E, Agnoletti V. Continuous intrathecal infusion for refractory pain management in an oncologic patient in intensive care. INDIAN JOURNAL OF PAIN 2022. [DOI: 10.4103/ijpn.ijpn_6_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
24
|
Spirituality in Coping with Pain in Cancer Patients: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9121671. [PMID: 34946397 PMCID: PMC8701851 DOI: 10.3390/healthcare9121671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Revised: 11/26/2021] [Accepted: 11/30/2021] [Indexed: 11/17/2022] Open
Abstract
Spirituality has been identified as an adaptive coping strategy and a predictor of better quality of life in cancer patients. Despite the relevance of spirituality in the health-disease process, it is noted that the assessment of the impact of spirituality in coping with pain is still incipient. The objective of this study is to assess the impact of spirituality in coping with pain in cancer patients. This quantitative cross-sectional study was carried out in a medium-sized hospital and a cancer patient support institution located in northeastern Brazil. A questionnaire with sociodemographic and clinical variables was used and the following instruments were applied: Visual Analogue Scale (VAS); Short-Form McGill Pain Questionnaire (SF-MPQ); Neuropathic Pain 4 Questions (DN4); Spiritual Wellbeing Scale (SWBS); WHOQOL Spirituality, Religiousness and Personal Beliefs (WHOQOL-SRPB). Most people with no pain had higher scores on the SWBS. Neuropathic pain was identified in 23 patients and was associated with the highest level of spirituality used as a way of coping with pain. As faith increases, pain decreases in intensity by 0.394 points. On the other hand, as inner peace increases, pain increases by 1.485 points. It is concluded that faith is a strategy for coping with pain, in particular neuropathic pain, minimizing its intensity. On the other hand, greater levels of inner peace allow to increase the awareness of the painful sensation. It is expected that these findings may be useful to integrate spirituality care in healthcare facilities as a resource for positive coping for people in the process of becoming ill, contributing to the therapeutic path and favouring a new meaning to the experience of the disease.
Collapse
|
25
|
[Applicability of QUIKS in conservatively treated tumor inpatients]. Schmerz 2021; 36:342-349. [PMID: 34705120 PMCID: PMC9512755 DOI: 10.1007/s00482-021-00599-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/18/2021] [Accepted: 09/21/2021] [Indexed: 11/11/2022]
Abstract
Hintergrund „Qualitätsverbesserung im konservativen Schmerzmanagement“ (QUIKS), das Modul für nichtoperative Patienten welches an das „QUIPS“-Projekt angelehnt ist, wurde an einer Kohorte Tumorpatienten auf Anwendbarkeit getestet. Material und Methoden Prospektiv wurden stationär konservativ behandelte Patienten am Universitätsklinikum Würzburg (UKW) anhand des Ergebnisfragebogens QUIKS zur Qualität der Schmerztherapie befragt (AZ 129/17, Ethikkommission am UKW). Informationen zur Therapie und Demografie wurden dem klinikinternen Dokumentationssystem entnommen. Ergebnisse Im Erfassungszeitraum konnten 100 Tumorpatienten aus verschiedenen Kliniken eingeschlossen werden. 74 % der Patienten benötigten Unterstützung bei der Beantwortung des Fragebogens. Funktionelle Einschränkungen oder schmerztherapiebedingte Nebenwirkungen lagen bei 77 % der Patienten vor, im Durchschnitt lagen Schmerzen von 6 auf der numerischen Rating-Skala vor. Die am häufigsten benannten Schmerzentitäten waren Rücken- und Kopfschmerzen. 18 % der Patienten erhielten eine Schmerztherapie mit Opioiden, 26 % mit Nichtopioiden, eine Anpassung der Schmerztherapie erfolgte in 5 % mit Opioiden und in 44 % mit Nichtopioiden, ein Einbezug schmerzmedizinischer Spezialisten erfolgte in 9 %. Fazit Die Anwendung des Fragebogens wurde von den Patienten gut akzeptiert, war jedoch mit einem großen Maß an Unterstützung beim Ausfüllen verbunden. Es zeigte sich ein hohes Schmerzniveau während des Krankenhausaufenthalts. Eine Anpassung der Schmerztherapie oder ein Einbezug schmerzmedizinischer Spezialisten erfolgte selten. Die Interpretation bzgl. Aussagen zur Qualität des Schmerzmanagements könnte eingeschränkt sein, da andere (vorbestehende) Schmerzentitäten, wie nichttumorassoziierter Schmerz oder chronischer Tumorschmerz, nicht eindeutig abgrenzbar sind. Zusatzmaterial online Die Online-Version dieses Beitrags (10.1007/s00482-021-00599-6) enthält die QUIKS-Prozessparameter und den QUIKS-Ergebnisfragebogen.
Collapse
|
26
|
Aoki CT, Moura RA, Ferreira LA, Mendes MG, Santos DC, Rezende MJ, Gomez MV, Castro-Junior CJ. Isobolographic analysis reveals antinociceptive synergism between Phα1β recombinant toxin and morphine in a model of cancer pain in C57BL/6J mice. J Venom Anim Toxins Incl Trop Dis 2021; 27:e20210027. [PMID: 34512739 PMCID: PMC8388195 DOI: 10.1590/1678-9199-jvatitd-2021-0027] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Accepted: 03/29/2021] [Indexed: 01/13/2023] Open
Abstract
Background: Phoneutria nigriventer venom contains Phα1β. This toxin and its recombinant form have a remarkable analgesic potential that is associated with blockage of voltage-gated calcium channels and TRPA1 receptors. Although morphine is a mainstay drug to treat moderate and severe pain related to cancer, it has serious and dose-limiting side effects. Combining recombinant Phα1β and morphine to treat pain is an interesting approach that has been gaining attention. Therefore, a quantitative and reliable method to establish the strength of the antinociceptive interaction between these two substances is necessary. The present study was designed to investigate the nature of the functional antinociceptive (analgesic) interaction between Phα1β recombinant toxin and morphine in a model of cancer pain. Methods: Melanoma was produced by intraplantar inoculation of B16-F10 cells into the right paw of C57BL/6J mice. Von Frey filaments measured the paw-withdrawal threshold after intrathecal administration of morphine, recombinant Phα1β, and their combination. Thermal hyperalgesia was assessed using Hargreaves apparatus. The degree of interaction was evaluated using isobolographic analysis. Spontaneous and forced motor performance was assessed with the open-field and rotarod tests, respectively. Results: Co-administration of recombinant Phα1β and morphine synergistically reverses the melanoma-induced mechanical hyperalgesia. The potency of the mixture, measured as the effective dose to reach 50% of maximum possible effect (MPE) in ameliorating mechanical hyperalgesia, was about twice fold higher than expected if the interaction between morphine and recombinant Phα1β was merely additive. Treatment with the combination at doses necessary to reach 50% of MPE caused no spontaneous nor forced motor alterations. Conclusion: The combinatorial use of recombinant Phα1β and morphine allows significant and effective dose reduction of both agents, which has translational potential for opioid-sparing approaches in pain management related to cancer.
Collapse
Affiliation(s)
- Caio Tavares Aoki
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Rodrigo Andrade Moura
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Luana Assis Ferreira
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Mariana Garcia Mendes
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Duana Carvalho Santos
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Marcio Junior Rezende
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Marcus Vinícius Gomez
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| | - Célio José Castro-Junior
- Graduate Program in Health Sciences, Institute of Education and Research, Santa Casa de Belo Horizonte, Belo Horizonte, MG, Brazil
| |
Collapse
|
27
|
Assessment Tools of Patient Competences: The Spanish Version of the R-NPQ and Three Practical Cases in Women with Breast Cancer and Persistent Pain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094463. [PMID: 33922314 PMCID: PMC8122815 DOI: 10.3390/ijerph18094463] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 04/15/2021] [Accepted: 04/20/2021] [Indexed: 12/04/2022]
Abstract
Persistent pain following treatment for breast cancer (PPBCT) is a prevalent and complex clinical issue. Education together with physiotherapy have been shown to lessen pain and disability in chronic pain. Although the evaluation of the patient’s competences is a major part of the educational program, the published educational programs rarely describe the tools used to assess competences, especially regarding those related to decision-making and problem-solving. The aim of this study was to provide two competences assessment tools: the cross-cultural adaptation and validation of the Spanish version of the Revised Neurophysiology of Pain Questionnaire (R-NPQ) and practical cases of women with PPBCT. The Spanish cross-cultural adaptation was conducted following recognized criteria. Measurement properties testing included an analysis of construct validity (known-groups approach), reliability (internal consistency and test-retest reliability), responsiveness, interpretability, and feasibility. To promote a tool that would allow evaluation of the educational program competences, a group of experts developed three cases extracted from real contexts by means of an iterative process. A total of 80 women with PPBCT (mean age 56 years) and 81 physiotherapy students (mean age 20 years) participated in the measurement properties analysis. The three developed cases were presented to the same 80 women with PPBCT before and after the educational program. As we expected, students showed a significantly higher score (p < 0.001) than did women with PPBCT in the R-NPQ questionnaire, with a large effect size (d = 2.49), demonstrating good construct validity. The Cronbach alpha was 0.90 (95% CI, 0.87–0.92) and the intraclass correlation coefficient was 0.82 (95% CI, 0.73–0.88). A large effect size (5.2) was found, as we expected, between baseline and post-treatment scores, suggesting adequate responsiveness. In addition, identifying and analyzing, decision making, communicating needs, knowing how to manage, and problem-solving skills were evaluated through the three practical cases. Most women (88.75%) reached the highest level in the assessment rubric of the proposed practical cases. The Spanish R-NPQ is a comprehensible, valid, reliable, and responsive tool for Spanish women with PPBCT. The practical cases are a useful competence assessment tool and were well accepted by women with PPBCT. Further studies are needed to investigate more competence assessment tools and to investigate whether the achievement of different levels of competences has an effect on health behaviors.
Collapse
|
28
|
An Overview of Current Recommendations and Options for the Management of Cancer Pain: A Comprehensive Review. Oncol Ther 2020; 8:251-259. [PMID: 32894414 PMCID: PMC7683745 DOI: 10.1007/s40487-020-00128-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Indexed: 01/07/2023] Open
Abstract
It is estimated that one-third of oncologic patients in the USA do not receive analgesia proportional to or adequate for the intensity of their pain. A mechanism-based approach to oncologic pain therapy is critical to ensure that analgesia regimens are individualized and effective. Since the mechanisms that lead to cancer pain are complex, healthcare providers must be willing to elicit and recognize the symptoms of each individual patient since these factors influence both the experience of pain and response to treatment. This process is centered on the use of detailed history in order to understand symptom expression in the context of primary tumor diagnosis and progression, history of cancer pain, psychological distress, sleep disturbances, cognitive function, and addictive behavior. Incorporating all of these factors into the assessment of a patient's pain condition can facilitate management decisions and help predict patient response to treatment.
Collapse
|
29
|
Zheng C, Chen X, Weng L, Guo L, Xu H, Lin M, Xue Y, Lin X, Yang A, Yu L, Xue Z, Yang J. Benefits of Mobile Apps for Cancer Pain Management: Systematic Review. JMIR Mhealth Uhealth 2020; 8:e17055. [PMID: 32012088 PMCID: PMC7005688 DOI: 10.2196/17055] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 12/11/2019] [Accepted: 12/15/2019] [Indexed: 12/24/2022] Open
Abstract
Background Pain ratings reported by patients with cancer continue to increase, and numerous computer and phone apps for managing cancer-related pain have been developed recently; however, whether these apps effectively alleviate patients’ pain remains unknown. Objective This study aimed to comprehensively evaluate the role of mobile apps in the management of cancer pain. Methods Literature on the use of apps for cancer pain management and interventions, published before August 2019, was retrieved from the following databases: MEDLINE, Embase, Cochrane, CINAHL, Scopus, and PsycINFO. The effects of apps on cancer pain were evaluated using RevMan5.3 software, and the rates of adverse drug reactions were analyzed using the R Statistical Software Package 3.5.3. Results A total of 13 studies were selected for the analysis: 5 randomized controlled trials (RCTs), 4 before-after studies, 2 single-arm trials, 1 prospective cohort study, and 1 prospective descriptive study. The 5 RCTs reported data for 487 patients (240 patients in the intervention group and 247 patients in the control group), and the remaining studies reported data for 428 patients. We conducted a meta-analysis of the RCTs. According to the meta-analysis, apps can significantly reduce pain scores (mean difference [MD]=–0.50, 95% CI –0.94 to –0.07, I2=62%, P=.02). We then used apps that have an instant messaging module for subgroup analysis; these apps significantly reduced patients’ pain scores (MD=–0.67, 95% CI –1.06 to –0.28, I2=57%, P<.01). Patients using apps without an instant messaging module did not see a reduction in the pain score (MD=0.30, 95% CI –1.31 to 1.92, I2=70%, P=.71). Overall, patients were highly satisfied with using apps. Other outcomes, such as pain catastrophizing or quality of life, demonstrated greater improvement in patients using apps with instant messaging modules compared with patients not using an app. Conclusions The use of apps with instant messaging modules is associated with reduced pain scores in patients with cancer-related pain, and patient acceptance of these apps is high. Apps without instant messaging modules are associated with relatively higher pain scores. The presence of an instant messaging module may be a key factor affecting the effect of an app on cancer pain.
Collapse
Affiliation(s)
- Caiyun Zheng
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China.,School of Pharmacy, Fujian Medical University, Fuzhou, China
| | - Xu Chen
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Lizhu Weng
- Department of Pharmacy, Xiamen Maternity and Child Care Hospital, Xiamen, China
| | - Ling Guo
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Haiting Xu
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Meimei Lin
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Yan Xue
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Xiuqin Lin
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Aiqin Yang
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Lili Yu
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Zenggui Xue
- Department of Pharmacy, Fuqing City Hospital, Fuzhou, China
| | - Jing Yang
- School of Pharmacy, Fujian Medical University, Fuzhou, China.,Department of Pharmacy, Fujian Medical University Union Hospital, Fuzhou, China
| |
Collapse
|
30
|
Lin QM, Pang NH, Li YH, Huang HL, Zhang XD, Hu GX, Wang ZS. Investigation of the effects of axitinib on the pharmacokinetics of loperamide and its main metabolite N-demethylated loperamide in rats by UPLC-MS/MS. Chem Biol Interact 2019; 310:108744. [PMID: 31299239 DOI: 10.1016/j.cbi.2019.108744] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/30/2019] [Accepted: 07/08/2019] [Indexed: 01/10/2023]
Abstract
The epidemic of loperamide abuse and misuse in the patients for the alternative to opioids has become an increasing worldwide concern and has led to considerations about the potential for drug-drug interactions between loperamide and other combined drugs, especially inhibitors of cytochrome P450 (CYP450) enzymes, such as axitinib. This study assessed the effects of axitinib on the metabolism of loperamide and its main metabolite N-demethylated loperamide in rats and in rat liver microsomes (RLM), human liver microsomes (HLM) and recombinant human CYP3A4*1. The concentrations of both compounds were determined by ultra-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS). The exposures (AUC(0-t), AUC(0-∞) and Cmax) of loperamide and N-demethylated loperamide showed a conspicuous increase when loperamide was co-administered with axitinib. The Tmax of loperamide increased while CLz/F decreased under the influence of axitinib. In vitro, axitinib inhibited loperamide metabolism with the IC50 of 18.34 μM for RLM, 1.705 μM for HLM and 1.604 μM for CYP3A4*1, and it was confirmed as a non-competitive inhibitor in all enzymes. Taken together, the results indicated that axitinib had an obvious inhibitory impact on loperamide metabolism both in vivo and in vitro. Thus, more attention should be paid to the concurrent use of loperamide and axitinib to reduce the risk of unexpected clinical outcomes.
Collapse
Affiliation(s)
- Qian-Meng Lin
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
| | - Ni-Hong Pang
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
| | - Ying-Hui Li
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
| | - Huan-le Huang
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
| | - Xiao-Dan Zhang
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China
| | - Guo-Xin Hu
- School of Pharmaceutical Sciences, Wenzhou Medical University, Wenzhou, 325035, Zhejiang Province, China.
| | - Zeng-Shou Wang
- Department of Pharmacy, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, 325027, Zhejiang Province, China.
| |
Collapse
|