scholarly journals Ganglion Impar Neurolysis in the Management of Pelvic and Perineal Cancer-Related Pain

2020 ◽  
Vol 13 (1) ◽  
pp. 29-34
Author(s):  
Filipa Ferreira ◽  
Ana Pedro
Keyword(s):  
Cancer Patients ◽  
Pain Control ◽  
Figo Stage ◽  
Perineal Pain ◽  
Who Analgesic Ladder ◽  
Anorectal Pain ◽  
Fourth Step ◽  
Invasive Techniques ◽  
Ganglion Impar

Cancer-related pain is a very prevalent problem in all stages, with 10% of patients requiring invasive techniques for adequate pain management. Ganglion impar neurolysis has been used in the treatment of pelvic-perineal pain with efficacy and rare complications, but only a few case or series reports in cancer patients have been published. We report the case of a patient presenting with an ovarian carcinoma (FIGO stage IIIC), who had several disease relapses at the colorectal transition and need for palliative colic prosthesis. She presented later with anorectal pain associated with a rectovaginal fistula, which had an important impact on the activities of her daily life. She was submitted to two ganglion impar neurolyses, which resulted in improved pain control for a total of 5 months, an important improvement in her quality of life, and reduction of opioid consumption. The authors aim to alert to the importance of pain control and to address the fourth step of the WHO analgesic ladder as an option for cancer patients, including palliative patients.

scholarly journals A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Intensity Difference ◽  
Front Line ◽  
Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

scholarly journals Role of Oxycodone Hydrochloride in Treating Radiotherapy-Related Pain

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Yinxia Wang ◽  
Ligang Xing
Keyword(s):  
Quality Of Life ◽  
Side Effects ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Control ◽  
Analgesic Drugs ◽  
Oxycodone Hydrochloride ◽  
Radiation Esophagitis

Radiotherapy is commonly used to treat cancer patients. Besides the curable effect, radiotherapy also could relieve the pain of cancer patients. However, cancer pain is gradually alleviated about two weeks after radiotherapy. In addition, cancer patients who receive radiotherapy may also suffer from pain flare or radiotherapy-induced side effects such as radiation esophagitis, enteritis, and mucositis. Pain control is reported to be inadequate during the whole course of radiotherapy (before, during, and after radiotherapy), and quality of life is seriously affected. Hence, radiotherapy is suggested to be combined with analgesic drugs in clinical guidelines. Previous studies have shown that radiotherapy combined with oxycodone hydrochloride can effectively alleviate cancer pain. In this review, we firstly presented the necessity of analgesia during the whole course of radiotherapy. We also sketched the role of oxycodone hydrochloride in radiotherapy of bone metastases and radiotherapy-induced oral mucositis. Finally, we concluded that oxycodone hydrochloride shows good efficacy and tolerance and could be used for pain management before, during, and after radiotherapy.

What are the expectations and preferences of patients with ovarian cancer to a maintenance therapy? A NOGGO/GCIG/ENGOT-ov22 survey (Expression IV) in 2101 patients.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. e17096-e17096 ◽  
Author(s):  
Irena Rohr ◽  
Maren Keller ◽  
Radoslav Chekerov ◽  
Gülten Oskay-Özcelik ◽  
Rolf Richter ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Side Effects ◽  
Maintenance Therapy ◽  
Cancer Patients ◽  
Recurrent Disease ◽  
Figo Stage ◽  
Tumor Stage ◽  
Primary Diagnosis ◽  
Paper Version

e17096 Background: The primary aim of the survey was to investigate the expectations of European patients about maintenance therapy. Methods: A 24-item questionnaire was provided to ovarian cancer patients via internet or paper-version in9 European countries (Austria, Belgium, France, Germany, Italy, Romania, Slovenia, Finland and Turkey). Data was captured about demographics, tumor stage and therapy after first line and/ or recurrent disease and particularly about preferences of administration and expectations concerning a maintenance therapy. Results: Overall, 2101 questionnaires of ovarian cancer patients were evaluated. Over 63% of the patients were between 51 and 70 years (range 18-90). The majority of the patients were FIGO stage III at their primary diagnosis. 96% of the patients had a surgery and 93% received a chemotherapy. 38% of respondents had recurrent disease. 45% of the patients had already heard of and 29% received maintenance therapy. 85% of the patients heard about maintenance therapy from the doctor and 10% from other patients and 9% read about it on the internet. The four most disturbing side effects of maintenance therapy were polyneuropathy (37%), nausea (36%), loss of hair (34%) and vomiting (34%). The main objective of maintenance treatment for all patients was to increase the chances of cure (73%), followed by an improvement in the quality of life (47%) and the delay of tumor growth (37%). Many patients are willing to take a maintenance therapy until tumor progression (38%). 39% of the patients would prefer an oral administration and 29% do not have any preference for any specific administration. When we performed cross country sub-analysis between patients with primary diagnosis and relapse, or sub-analysis between patients who are actually receiving maintenance therapy or not, we observed no significant differences of expectations to a maintenance therapy. Conclusions: There is an urgent need for more information regarding side effects and treatment goals of maintenance therapy to avoid misunderstandings by the patient. This information may increase patient’s compliance for maintenance therapy in ovarian cancer.

Pain Education for Underserved Minority Cancer Patients: A Randomized Controlled Trial

2004 ◽  
Vol 22 (24) ◽  
pp. 4918-4925 ◽  
Author(s):  
Karen O. Anderson ◽  
Tito R. Mendoza ◽  
Richard Payne ◽  
Vicente Valero ◽  
Guadalupe R. Palos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
African American ◽  
Pain Management ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Control Group ◽  
Pain Education ◽  
Perceived Pain

Purpose Previous studies found that African American and Hispanic cancer patients are at risk for undertreatment of pain. We evaluated the efficacy of a pain education intervention for underserved minority patients. Patients and Methods Ninety-seven underserved African American and Hispanic outpatients with cancer-related pain were enrolled onto a randomized clinical trial of pain management education. The patients in the education group received a culture-specific video and booklet on pain management. The control group received a video and booklet on nutrition. A research nurse met with each patient to review the materials. We measured changes in pain intensity and pain-related interference 2 to 10 weeks after the intervention, as well as changes in quality of life, perceived pain control, functional status, analgesics, and physician pain assessments. Results Physicians underestimated baseline pain intensity and provided inadequate analgesics for more than 50% of the sample. Although the ratings for pain intensity and pain interference decreased over time for both groups, there was no statistically significant difference between groups. Pain education did not affect quality of life, perceived pain control, or functional status. African American patients in the education but not the control group reported a significant decrease in pain worst ratings from baseline to first follow-up (P < .01), although this decrease was not maintained at subsequent assessments. Conclusion Brief education had limited impact on pain outcomes for underserved minority patients, suggesting that more intensive education for patients and interventions for physicians are needed.

scholarly journals A Challenging Case of Ganglion Impar Block in a Patient with Coccygeal Deformity and Rectal Resection from Metastatic Rectal Cancer

2017 ◽  
pp. 71-77
Author(s):  
Kevin Wong
Keyword(s):  
Quality Of Life ◽  
Rectal Cancer ◽  
Rectal Resection ◽  
World Health ◽  
Perineal Pain ◽  
Patients With Cancer ◽  
Chronic Perineal Pain ◽  
Ganglion Impar Block ◽  
Ganglion Impar

The ganglion impar is a solitary retroperitoneal structure that marks the termination of paravertebral sympathetic chains in the presacral space and receives nociceptive inputs from pelvic organs. Chronic perineal pain (CPP) in patients with advanced cancer can be very debilitating. Ganglion impar block can ameliorate CPP and hence, improve quality of life. Here, we describe the case of a 65-year-old woman with a deformed coccyx caused by childhood trauma and rectal resection from rectal cancer who presented with CPP that substantially affected her quality of life. She was unable to tolerate the side effects of World Health Organization Step 3 analgesics. The patient underwent ganglion impar block that was challenging due to anatomical abnormalities. There was significant immediate and long-term improvement in quality of life and disease coping in our patient after the ganglion impar block. She was able to restore physical activity, decrease the need for potent opioids, and improve sleep quality. We conclude that a ganglion impar block can effectively treat CPP, and in palliative settings, neurolytic ablation can be considered. It is often challenging in patients with cancer due to anatomical abnormalities. Further studies are needed in patients with cancer who have CPP given the suggestion of a better quality of life after ganglion impar block. Key words: Ganglion impar, chronic perineal pain, quality of life, cancer pain, coccyx

Quality of life in school-age pediatric cancer patients

2013 ◽  
Author(s):  
Fransisca M. Sidabutar ◽  
Anggie Regia Anandari ◽  
Ingrid Karli ◽  
Yusnita Katagori ◽  
Henny E. Wirawan
Keyword(s):  
Quality Of Life ◽  
Cancer Patients ◽  
Pediatric Cancer ◽  
School Age ◽  
Pediatric Cancer Patients
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