Journal of pain and symptom management
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Until now, there have not been any parameters to monitor opioid therapy in cancer patients with pain. In this study, 325 consecutive advanced cancer patients were scheduled for a prospective longitudinal survey. After exclusions, 67 patients were surveyed. ⋯ Psychological factors were associated with poor pain relief, probably reducing the patient's compliance. The tools used in this study may be useful in monitoring the effects of opioid therapy in cancer pain patients. Simple numbers are easy to compare and make it possible to profile opioid responsiveness and differences among patients.
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Dyspnea is frequently a multicausal and devastating symptom among advanced cancer patients. It occurs in 21%-78.6% of patients days or weeks before death and is often difficult to control. The genesis and pathophysiology of dyspnea as a symptom still has not been well understood. ⋯ This might also explain why about 24% of dyspneic cancer patients do not present cardiac/pulmonary disease. In addition, two other possible mechanisms of dyspnea have been proposed: chemoreceptor stimulation and efferent activity from the respiratory center by direct ascending stimulation. These factors and the assessment tools used in patients with chronic dyspnea are summarized in this review.