Journal of the National Comprehensive Cancer Network : JNCCN
-
J Natl Compr Canc Netw · Jul 2003
Assessment of pain caused by invasive procedures in cancer patients.
Invasive procedures are commonly required in the diagnosis and management of cancer in adults. However, little is known regarding the prevalence and severity of procedure-related pain in this patient population. This prospective study was conducted to determine the frequency and types of invasive procedures performed in a large comprehensive cancer center, the intensity of pain associated with these procedures, the types of periprocedural analgesics administered, and how these patients would like their procedural pain to be managed in the future. ⋯ There was no statistical relationship between patients' pain ratings and their satisfaction with the pain control they received during the procedures. This study represents the largest descriptive study of procedural pain in adult cancer patients. As more than 50% of these patients experienced moderate to severe pain during procedures, further studies are needed to improve the control of procedure-related pain in patients with cancer.
-
J Natl Compr Canc Netw · Jul 2003
Practice GuidelineDistress management. Clinical practice guidelines.
The evaluation and treatment model expressed in the NCCN Distress Management Guidelines recommends that each new patient be rapidly assessed in the office or clinic waiting room for evidence of distress using a brief screening tool (the Distress Thermometer and Problem List) presented in Figure 1 (see page 369). A score of 5 or greater on the thermometer should trigger further evaluation and referral to a psychosocial service. The choice of which service should be determined by the problem areas specified on the Problem List. ⋯ Presently, the quality of the psychological care patients receive is not routinely monitored. Accrediting bodies have not directly examined the quality of psychosocial care, nor have they established minimal performance standards for its delivery. The panel believes that psychosocial care should and will eventually be on our institution's report cards.
-
J Natl Compr Canc Netw · Jul 2003
Seeking drug treatment for OxyContin abuse: a chart review of consecutive admissions to a substance abuse treatment facility in Kentucky.
The abuse of prescription opioids has been reported to be on the rise and has gained much public attention, especially given the recent media coverage devoted to the abuse of sustained-release oxycodone (OxyContin, Purdue Pharma LP, Stamford, CT). We tracked admissions to our substance abuse program to put OxyContin abuse into perspective as a presenting problem in the region. A total of 258 admissions to a psychiatric facility for opioid dependence over a 15 month period, for the treatment of prescription opioid abuse, were examined in this chart-review study. ⋯ Polysubstance abuse, including OxyContin abuse, was a significant presenting problem to our Addictive Disease Unit between October 2000 and December 2001. Although this chart-review study is not designed to be indicative of the epidemiology of OxyContin abuse, it offers some insight into the nature of this phenomenon in a particular region during the height of public attention paid to it. A follow-up prospective study to examine this phenomenon in multiple regions, further away chronologically from the increased media attention, is underway.
-
Cancer-related fatigue (CRF) is the most prevalent symptom of cancer, occurring in 60% to 90% of patients and surpassing pain in frequency. CRF may increase patients' anxieties and hamper their quality of life. ⋯ Since then, we have gained clinical insights into the planning, development, and evolution of this endeavor. Our objective is to share our experiences and provide preliminary analysis of the first 123 patients evaluated in this clinic.