Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Natural and synthetic opioid compounds, either alone or in combination with other drugs, are widely used analgesics for patients with both acute and chronic pain. Decades of extensive pharmacologic investigations have characterized three high-affinity cell-surface neuronal receptors, the activation of which is responsible for both the desirable properties (antinociception) and undesirable properties (respiratory depression, nausea and vomiting, dependence, etc.) of opioid drugs. Recent research in molecular biology and pharmacogenetics in relation to opioids and their receptors has helped clarify previous pharmacologic observations and has laid the groundwork for new analgesic therapies with improved therapeutic outcomes.
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Support Care Cancer · Mar 2005
Comparative StudySymptoms, treatment and "dying peacefully" in terminally ill cancer patients: a prospective study.
The aims of this study were to describe the symptoms, their treatment during the final months of life of terminally ill cancer patients and to assess characteristics of the dying process. ⋯ The results give insight into the nature of suffering and factors related to the dying process of terminally ill cancer patients. Attention to psychosocial well-being and to the need to be with loved ones appears to be essential for patients' quality of life.
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GOALS AND WORK: Despite medical awareness, intractable pain is a serious problem in cancer and occurs in up to 2% of advanced cancer patients. However, few data are available concerning the optimal treatment of such patients. The emergence of intractable pain may notably be due to the activation of N-methyl-D-aspartate (NMDA) receptors located in the central nervous system. NMDA antagonists might thus be an interesting approach in such pain syndromes. ⋯ Our data suggest the importance of NMDA receptors in the genesis of chronic cancer pain and indicate that NMDA antagonists should be further studied for the management of cancer pain and, in particular, intractable pain.