Gan to kagaku ryoho. Cancer & chemotherapy
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Gan To Kagaku Ryoho · Feb 2008
Comparative Study[Clinical outcome of totally implantable subcutaneous infusion port--comparison with home parenteral nutrition and chemotherapy].
We investigated long-term clinical findings in a total of 107 cases with a subcutaneous infusion port. Some 109 patients were implanted with a subcutaneous infusion port at our institution from 1994 to 2003. The patients' ages ranged from 1 to 93 years (average 58.1 years). ⋯ This catheter system is useful for improvement of patient's quality of life. However, once complications occur, patient's condition might become worse. Appropriate measures must be taken when complications occur.
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At the 13th Oncology Forum, future directions of anticancer drug development in Japan were discussed. Development of anticancer drugs in the 1990s was based on the concept of total cell kill, but now development of molecular targeted drugs becomes the mainstream. Unfortunately, molecular targeted drugs and antibody agents are mostly foreign products and translational research in Japan is poor as it stands now. ⋯ When participating in an international collaborative study, Japan needs to recruit subjects at a speed similar to the rest of the world, but differences in medical environment including clinical trials pose a problem. To solve this problem, it is considered effective not only to pursue the Western environment but also to improve staff such as nurses and CRC. The number of Japanese patients necessary for Phase III studies is individual developmental strategy and needs to be examined by both companies and regulatory agencies.
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It is essentially important for home hospice care, which provides hospice care at home to palliate the patient's sufferings, such as pain for example, and to provide cares in the form of the interdisciplinary team approach. Though the actual way of providing hospice care at home is principally based upon an institutional hospice care, there are some which are peculiar to home hospice care. The principles of symptom control in case of home hospice care are: (1) to take account of patient's daily life, (2) to make much of the natural course of the disease, (3) to palliate the patient's sufferings by focusing on the subjective complaints and (4) to provide relief on medical aspect at home. As for the interdisciplinary team approach, a special consideration of the members to visit the patient's home as few as possible in order to keep the patient's life quiet.
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This paper reviews current cancer pain management guidelines, the challenge of managing pain across the care settings hospital to home. This also presents up-to-date information on the medications and strategies and the expansion of the World Health Organization's (WHO) analgesic ladder with several classes of drugs that are currently used to treat cancer pain: (1) non-steroidal anti-inflammatory drugs (NSAIDs), (2) opioid analgesics with opioid rotation and the control for side effect of opioid, (3) adjuvant analgesics including ketamine.
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Gan To Kagaku Ryoho · Dec 2007
[An attitude survey on the medical use of narcotics for cancer pain relief].
Narcotic medications are the major drug therapy for cancer pain relief. A clinical use of fentanyl patches and oxycodone extended-release tablets has recently become available, which led to more choices of narcotics to be used medically. On the other hand, palliative care systems have not yet been fully established by medical institutions. ⋯ The result showed that the recognition rate of morphine used for cancer pain relief was 88%, while the recognition rate of narcotics for medical use other than morphine available for cancer pain relief was 20%. The most acceptable dosage form of narcotics was a skin patch, followed by an oral preparation. A response percentage that the dosage form of medical narcotics should be selectable by users was 93%.