Nihon rinsho. Japanese journal of clinical medicine
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With the development of the medical oncology, the progress of the diagnosis and the treatment for cancer patients have provided the improvement of overall survival rates. Furthermore, the importance of the palliative care, which give the relief of the pain and maintain or improve quality of life in cancer patients, has become to be recognized recently. ⋯ Therefore, an interdisciplinary collaboration with a variety of experts is required for palliative care. Although there is a lot of problem to be solved for palliative care in Japan, each expert should investigate his own speciality but also collaborate with another.
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The accurate assessment of pain is needed to control cancer pain and its treatment. Pain itself is subjective experience and is difficult to estimate quantitatively. Until now, there is no precise method to quantitate the cancer pain objectively. ⋯ Molecular biological approach has been advanced in the neuroscience field to find the candidate of neuropathic pain. In this article, we would like to show the results of the proteomics research for neuropathic pain. We also tried to discuss about the biomarker and its possibility whether it can reflect cancer pain and effect of cancer treatment.
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Opioids are main drugs in pain management for terminal cancer patients. In these days, we have to choice suitable opioids for the terminal cancer patients with severe pain by opioids rotation. Morphine is a basic drug in opioids. ⋯ For example, timing for administrating opioids, titration, rescue dose, and side effects were included in this article. We don't have to remember the aim of pain management. Pain control is not a purpose, but a way for keeping QOL of the terminal cancer patients.
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Recent advances in cancer pain management resulted with rapid spread of variety of opioids in Japan. During these two decades, many controlled release morphines for cancer pain management have been released in the Japanese market. ⋯ In this article, the feature and direction of each controlled release morphine are described. Moreover, the target and method of cancer pain treatment are also described.
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It is important for pharmacists to remove patients' anxiety and misunderstanding about cancer pain management with opioids. Furthermore, we need to explain how to take opioids as well as its effects and side-effects and make sure they are correctly understood so that patients and their family members adequately use the medicine. Here describes the patient education which aims to remove patients' anxiety and misunderstanding about opioids and urge patients to be proactively involved in cancer pain management.