Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
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Support Care Cancer · May 2015
ReviewPharmacological options for the management of refractory cancer pain-what is the evidence?
Refractory cancer pain that does not respond to standard opioid and/or co-analgesic therapy occurs in 10-20 % of patients. Risk factors include young age, neuropathic pain type, incident pain, psychological distress, previous opioid use, high tolerance, a history of addiction and impaired cognition. The management of patients with refractory pain remains a challenge. ⋯ The evidence of benefit for any of these agents is weak, and each additional agent increases the risk of adverse events. Evidence-based guidelines cannot, therefore, be developed at present. New approaches are recommended including targeted opioid therapy, multimodal analgesia, a goal-oriented approach to pain management and increasing use of the multidisciplinary team and support services.
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Support Care Cancer · May 2015
Randomized Controlled TrialPre-consultation educational group intervention to improve shared decision-making for postmastectomy breast reconstruction: a pilot randomized controlled trial.
Breast cancer survivors who make preference-sensitive decisions about postmastectomy breast reconstruction often have large gaps in knowledge and undergo procedures that are misaligned with their treatment goals. We evaluated the feasibility and effect of a pre-consultation educational group intervention on the decision-making process for breast reconstruction. ⋯ A pre-consultation educational group intervention improves patients' shared decision-making quality compared to routine preoperative patient education. A full-scale definitive RCT is warranted based on high feasibility outcomes, and the primary outcome for the main trial will be decisional conflict.
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Support Care Cancer · May 2015
Adaptation of an evidence-based clinical practice guideline in cancer pain management by medical oncologists: a case vignette study.
Pain is a major problem in all cancer stages. Cancer pain guidelines are developed to improve management of pain. It is unclear whether these recommendations are applied in daily practice. Therefore, the objective of this study was to assess medical oncologists' adherence to an evidence-based clinical practice guideline in cancer pain management and their confidence in treatment choices. ⋯ The recommendations of the guideline have been partly adopted in cancer pain practice by medical oncologists. Particularly, pain assessment is not applied in the recommended manner. Therefore, implementation strategies should focus on adequate pain assessment in patients with cancer.
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Support Care Cancer · May 2015
Oral-health-related quality of life in patients with cancer: cultural adaptation and the psychometric testing of the Persian version of EORTC QLQ-OH17.
To evaluate the validity, reliability, responsiveness to treatment, and gender invariance of the Persian version of the European Organization for Research and Treatment of Cancer Oral Health Questionnaire (QLQ-OH17) among Iranian cancer patients. ⋯ The Persian version of QLQ-OH17 is a valid and reliable questionnaire for assessing OHRQoL in Iranian patients with various cancers.
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Support Care Cancer · May 2015
Observational StudyLong-term efficacy and tolerability of intranasal fentanyl in the treatment of breakthrough cancer pain.
The aim of the present study was to assess the long-term tolerability and efficacy of intranasal fentanyl (INFS) in opioid-tolerant patients with breakthrough cancer pain (BTP). ⋯ The long-term use of INFS in advanced cancer patients is effective and safe. No serious adverse effects were found up to six months of assessment. The level of quality of sleep and patients' satisfaction was relatively good, considering the advanced stage of disease.