Current opinion in supportive and palliative care
-
Curr Opin Support Palliat Care · Aug 2007
ReviewOpioids for chronic pain: molecular and genomic basis of actions and adverse effects.
Opioid analgesics are being increasingly used for pain control in both cancer and noncancer patients. Despite thousands of years of their use, the biological basis of their action and adverse effects are only now being understood. It is important to understand these agents better so that the potentially large sections of the population who may eventually be eligible to receive therapeutic opioids are treated rationally and safely. ⋯ Understanding the biological basis of how opioids work and produce adverse effects should help us to make better choices of which drugs to use for specific populations. Identifying individual genetic differences in opioid receptors and drug metabolism pathways may also pave the way to more targeted and safer medication in the future.
-
Curr Opin Support Palliat Care · Apr 2007
ReviewBereavement in families with relatives dying of cancer.
The aim of this review is to examine the new conceptualization on bereavement and, more specifically, on grief and bereavement in family members of patients who have died of cancer ⋯ It is important to understand the suffering endured by family members of patients dying of cancer and the consequences of bereavement. A careful and systematic exploration of the risk factors for pathological bereavement is important for optimal psychosocial care of family members in palliative medicine programs and community medicine.
-
As patients enter the palliative phase of their illness, both physical and psychological burdens change. Anxiety commonly increases as patients become aware of both the relative ineffectiveness of medical treatments in halting the progress of their disease and, consequently, their limited life expectancy. This review will allow clinicians to be more effective in helping patients manage their psychological distress. ⋯ It is our hope that this article will inform oncologists, oncology nurses and mental health workers about the prevalence, assessment and treatment options for anxiety in advanced cancer patients. Unfortunately, there is a scarcity of research in this field; we hope that this article will encourage the motivation for more studies to assess different treatments for anxiety in this population.