Oncology
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Ovarian suppression has been used to treat hormone-responsive metastatic breast cancer in premenopausal women for over 100 years and is currently under continued evaluation for treatment in the adjuvant setting. In this article, ovarian suppression by surgery, radiation, and pharmacological therapy is discussed, including the risks, benefits, and efficacy of each strategy. The role of ovarian suppression in premenopausal women with early and advanced stages of breast cancer will be reviewed. It is hoped that this review will assist clinicians and their patients in selecting the appropriate therapy if ovarian suppression is indicated.
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The European Organization for Research and Treatment of Cancer Core Quality of Life Questionnaire (EORTC QLQ-C30) is composed of 5 multi-item function scales and 9 symptom scales. The Korean EORTC QLQ-C30 was drawn up by the EORTC itself. However, its validity and reliability in the palliative care has not been reported. The aim of this study was to evaluate the practicality, reliability, and validity of the Korean EORTC QLQ-C30 in terminally ill patients under cancer pain management. ⋯ Cronbach's alpha coefficient to judge internal consistency was very good except for cognitive functioning. The Korean QLQ-C30 has a strong validity in functional scales. Global quality of life, pain, fatigue, nausea, and sleep disturbance were improved after cancer pain management. These results support that the QLQ-C30 is a reliable and valid measure of quality of life in Korean cancer patients receiving cancer pain management. We consider that the QLQ-C30 can be used effectively in the palliative care settings in order to assess the effects of cancer pain management on quality of life of advanced-stage cancer patients.
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Metastatic bone pain is characteristic of cancer pain. Satisfactory analgesic effects are achieved in more than 70% of patients with cancer pain who receive a combination of nonsteroidal anti-inflammatory drugs and opioids, according to the WHO therapeutic guidelines. Morphine, oxycodone, and fentanyl are commonly administered opioids. ⋯ Palliative radiation was performed in 6 patients, resulting in pain relief in 4 and therefore the dose of opioids could be reduced. Bone metastasis should not be considered as the terminal stage, and decisions on the administration of drugs, in combination with radiation or orthopedic therapy, should be made at an early stage. Alleviation of pain and allowing a better quality of patient survival time, even if not for long, should be attempted.
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Comparative Study
Controlled-release oxycodone in the treatment of neuropathic pain of nonmalignant and malignant causes.
To assess the efficacy and safety of controlled-release oxycodone in patients with moderate to severe neuropathic pain of nonmalignant and malignant causes. ⋯ The use of opioids for neuropathic pain is not fully accepted by the majority of physicians at present. This study shows that controlled-release oxycodone is a safe, well-tolerated and effective medication for neuropathic pain.
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Among all the fields of specialization in medicine, the surgeons probably encounter the highest number of pain patients, aside from 'causing' many painful conditions due to surgical procedures. It was widely presumed that surgeons in general do not pay much attention to pain management of their patients, often passing on the responsibility to other specialists. ⋯ Although the majority of the respondents claim to be involved in the management of perioperative pain of their patients, an objective assessment of the patients' pain is not usually done. The use of opioids alone or in combination is still low among Filipino surgeons; the main reason could be the regulatory provisions of the government on opioid use.