Postgraduate medical journal
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The purpose of this study was to describe family factors which influence cancer pain. Previous research has focused on the patients' and professional caregivers' perspective of pain. ⋯ Findings of the study demonstrate family perceptions of pain, caregiver burden associated with pain, caregiver moods and differences in caregiver experiences of pain between three sites of care including a hospice, a community hospital and a cancer centre. Understanding the perspective of the family caregivers and their role in pain management can assist health care providers in management of the patient's pain.
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Morphine consumption for medical purposes in Japan showed a 17-fold increase between 1979 and 1989, due to increased use in cancer pain management. This increase is a reflection of the improving attitude of the health care professionals and health policy makers towards narcotics use. The WHO Cancer Pain Relief Programme has ultimately become the basis for a national cancer pain relief programme. The Ministry of Health and Welfare amended the Narcotics and Psychotropics Control Law in 1990, to improve accessibility of morphine preparations to cancer patients with pain, and edited four manuals for palliative care, that include guidelines on cancer pain relief, and legislative management of narcotics use in hospital, clinic and pharmacy.
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Pain management is an integral component of comprehensive cancer care. The combined goals of optimal comfort and optimal function require a working understanding of how pain therapy interacts with cancer and cancer therapy. The two main aspects of cancer which affect pain management are the cancer's treatability and its non-pain pathophysiology. ⋯ Pain therapy can impair cancer therapy by augmenting or complicating cancer therapy's adverse effects. Pain therapy can enhance cancer therapy by improving organ function and patient performance status permitting previously limited or contraindicated cancer therapies to be given. Five case studies are presented to illustrate how effective integration of pain management into comprehensive cancer care is mandatory for optimal care of cancer patients and their families.