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Volum 02, Numarul 1-2, 1996

The cancer pain and its consequences for the patient

Silvia Albu1, N. Ghilezan2

1 Sanitary Department Cluj-Napoca

2 U. M Ph. „Iuliu Haţieganu” Cluj-Napoca Department of Oncology and Radiotherapy

The cancer pain is a freqvent symptoms and as estimated by WHO, daily around 3,5 milion peoples are suffering more or less. For Romania in 1993, about 20.000 patients needed a specific treatment but despite the progress and the drugs available, the pain is still undertreated. The obstacles for a correct treatment of the cancer pain are mainly an inadequate training in the field, personal causes related to the patient himself and his family, and legislative regulations. The aim of this symposium is to address to all these problems and to look for a practical solution for our country.

Keywords: pain, importance, quality of life, treatment, training

Radioterapie & Oncologie Medicală, 1996, 1-2: 2-4

Cancer pain: mechanisms and syndromes

  1. Udrea

Oncological Institute „Prof I. Chiricuţă” Department of Radiotherapy II

This is a review of the physiopatology of pain, including somatic, neuropathic and visceral pain with their essential clinical, laboratory characteristics and treatment principles. There are also presented the most important characteris- tics of the following syndromes: osseous metastases, spinal cord compression, neural invasion, abdominal pain, mu- cositis and herpes virus neuropathy.

Keywords: somatic pain, neuropathic pain, visceral pain

Radioterapie & Oncologie Medicală, 1996, 1-2: 5-8

Analgesic drugs treatment

T.E. Ciuleanu

Oncological Institute „Prof I. Chiricuţă” Department of Medical Oncology

Use of the analgesics is done accordingly to the WHO analgesic scale, with specific drugs for each of the three levels of pain intensity. Prescription rules are including individual tailoring of the doses, oral administration as main route, ‘by clock” administration at fixed intervals, use of coanalgesic drugs, prophylactics of adverse effects, treatment of insom- nia, monitoring of the analgesic response. Drugs used the first level of pain include non-narcotic peripheral analgesics (acetaminophen and NSAIDs, including aspirin). The mode of action, the indications and the adverse affects, the criteria for selecting the most appropiate drug for a particular patient, as well as the available drug combinations are presented.

Keywords: pain, analgesics, non-opioid peripheral analgesics

Radioterapie & On cologie Medicală, 1996, 1-2: 9-16

Adjuvant treatment

Cristina Cebotaru

Institute of Oncology „Prof I.Chiricuţă” Department of Radiotherapy

Adjuvant treatment are used to enhance the efficacy of analgesic drugs, It consists of an heterogeneous group of drugs, with different structures and mechanisms of action: tricyclic anti-depressants, anticonvulsants and local anesthesics are mainly used in neurogenic pain, while neuroleptics and benzodiasepines have an antipsychotic, antispastic, antiemetic and anxiolytic action. Neurostimulants are useful in patients with good analgesia, but excesive sedation. Antispastics are used for imtermediare visceral pain, while in severe pain due to bone metastases, diphosphonates have made the proof of their efficacy. Adjuvant treatments must be sistematicaly used for each level of WHO analgesic scale.

Keywords: cancer pain, oncologic patients, adjuvant treatments

Radioterapie & Oncologie Mediclă, 1996, 1-2: 17-20

Antitumor treatments and their effects on cancer pain

  1. Cernea

UMPh „Iuliu Haţieganu” Cluj-Napoca Department of Oncology and Radiotherapy

Specific antitumor treatments through her cell killing action have an pronounced effect on cancer pain. Therapeutic indications and modalities are different fonD curative treatments. Treatment duration and aggressiveness are lesser, the main endpoint being the quality of patient’s life. Choosing such a treatment the balance between estimated benefit for the patient and the costs for the family and society is imperative.

Keywords: cancer, pain, antitumor treatments

Radioterapie & Oncologie Medicală, 1996, 1-2: 21-25

Corticosteroids In oncology

  1. Udrea

Oncological Institute „Prof I.Chiricuţă” Department of Radiotherapy II

Corticosteroids are used in oncology for their antitumoral, anti-inflammatory and symptomatic actions. This is a review of these indications and of the side efects, risk factors and contraindications. We are also proposing a general therapeutic schedule, begining with a dose of2-3 mgiKgiday of prednisone, prednisolone, methylprednisolone or 0,5 mg/Kg/day of dexamethazone or betamethazone followed by the lowest maintenance dose producing an acceptable response.

Keywords: corticosteroids, adverse effects, treatment schedule

Radioterapie & Oncologie Medicală, 1996. 1-2: 26-28

Chronic pelvic pain

  1. Costin

UMF „I. Haţieganu” Cluj-Napoca

1st Department of Obstetrics & Gynecology

Both diagnosis and management of chronic pelvic pain may be greatly facilitated by a multidisciplinary approach integrating specific medical interventions with cognitive-behavioral pain strategies and concurrent treatment of psy- chological morbidity. Anyone who has managed chronic pain patients well understands the need for patience and unconditional positive supportfor the patient. It is most imperative that the physician and the entire health care team continue to be optimistic in spite of repeated failures of different treatment regimens.

Keywords: chronic pelvic pain, pain perception

Radioterapie & Oncologie Medicală. 1996. 1-2: 29-32

The influence of the pain and of depression in oncological patients quality of life

Dana Cernea1, N. Ghilezan2

1 Institute of Oncology „Prof I. Chiricuţă „, Dept. Radiotherapy

2UMPh „Iuliu Haţieganu” Cluj Napoca, Dept. Oncology and Radiotherapy

The purpose of this article is to sensibilise the medical practitioner to the importance of quality of life in oncology. The patient is not alway treated with a curative intent, but his quality of life is very important. Pain and depression are

factors who affect the quality of life in 60 – 70 % of our patients. The intensity of this symptoms and the quality of life

can be quantified and they are important parameters in clinical trials. To be efficient in the treatment of the pain aned depression, doctors need the informed consent of patient, adapted to the patients social and cultural.

Keywords: pain, depression, quality of life

Radioterapie & Oncologie Medicală, 1996. 1-2: 33-38

Opiates drugs in the treatment of cancer cronic pain

Ileana Hica

Oncological Institute „Prof I.Chiricuţă”, Department of Intensive Care

We present the most important aspects of the clinical pharmacology of opiates and the principles of the pharmacologi- cal cancer chronic pain management.

Keywords: chronic pain, analgesics, opiates

Radioterapie & Oncologie Medicală. 1996. 1-2: 39-51

Management of pain in cancer patients

  1. Chossiere, F.Feuilhade, E.Levy, J.P. Le Bourgeois

Service du Professeur J.P. Le Bourgois Hôpital Henri Mondor

The paper deals with the most frequent types of pain encountered in oncology. The WHO classification for pain is utilized and the usual drugs on the French market are presented.

Key words: pain, analgesics, opiates

Radioterapie & Oncologie Medicală, 1996. 1-2: 52-55