Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · Jan 2005
Multicenter Study Clinical TrialEffectiveness and safety of oral extended-release oxymorphone for the treatment of cancer pain: a pilot study.
Inadequate analgesia and/or unmanageable adverse events frequently result in the need to rotate patients with cancer pain to a different opioid. The availability of a novel oral extended-release (ER) formulation of oxymorphone provides clinicians with another treatment option. In this study, we assessed the analgesic effectiveness and safety of the new oral ER formulation of oxymorphone following treatment with controlled-release (CR) morphine sulfate or oxycodone. ⋯ Cancer patients stabilized on morphine CR or oxycodone CR were safely and rapidly converted to a lower milligram dose of oxymorphone ER that provided adequate pain relief with comparable tolerability. These results justify additional trials with oxymorphone ER.
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In most cancer patients pain can be successfully treated with pharmacological measures using opioid analgesics alone or in combination with adjuvant analgesics (coanalgesics). Weak opioids are usually recommended in the treatment of moderate cancer pain. There is still a debate as to whether the second step of the WHO analgesic ladder comprising opioid analgesics such as tramadol, codeine, dihydrocodeine, and dextropropoxyphene is still needed for the treatment of cancer pain. ⋯ One of the most interesting and useful weak opioids is tramadol (Adolonta, Contramal, Nobligan, Top-Algic, Tramal, Tramal Long, Tramal Retard, Tramundin, Trodon, Ultram, Zydol). Its unique mechanism of action, analgesic efficacy and profile of adverse reactions have been the reason of performing many experimental and clinical studies with tramadol. In this article we summarize data on pharmacology, mechanisms of action, pharmacokinetics, side effects and clinical experience assessing analgesic efficacy, adverse reactions and safety of tramadol in cancer pain.
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Support Care Cancer · Jan 2005
Case ReportsPrompt control of bronchorrhea in patients with bronchioloalveolar carcinoma treated with gefitinib (Iressa).
Bronchorrhea is a condition in which voluminous sputum is produced daily, typically seen with bronchioloalveolar cell carcinoma (BAC). Unless the underlying cancer can be controlled, bronchorrhea causes substantial symptomatic distress. ⋯ Prompt resolution of these patients' bronchorrhea, dyspnea, and supplemental oxygen requirements are detailed. Given the limited success of alternative interventions, a trial of gefitinib should be considered for patients with bronchorrhea secondary to BAC.
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Support Care Cancer · Jan 2005
Stories from doctors of patients with pain. A qualitative research on the physicians' perspective.
The aim of this study was to explore the physicians' internal representation of the doctor-patient relationship in the dramatic field of the patient with pain. ⋯ The professional perspective seemed to be the only place in which physicians could "stop", a space not extreme in which they seemed to express the need for education about the management of the professional relationship with the other person.