Evaluating pain management practices for cancer patients among health professionals in cancer and supportive/palliative care units: a Belgian survey.

Background: Pain is reported in 66% of cancer patients with advanced disease. Adequate pain management is a cornerstone of comprehensive supportive cancer care.

Purpose: The purpose of this study was to assess pain management in Oncology Units in Belgium.

Efficacy and Safety of Lanreotide Autogel in the Treatment of Clinical Symptoms Associated With Inoperable Malignant Intestinal Obstruction: A Prospective Phase II Study.

Purpose: Inoperable malignant intestinal obstruction (IMIO) is a severe complication in patients with cancer, usually gastrointestinal or gynecologic in origin. For patients with IMIO, there is a need to relieve symptoms and limit nasogastric tube (NGT) use. Previous studies have suggested the efficacy of somatostatin analogues in relieving obstruction-related symptoms, such as nausea, vomiting, and pain.

Cannabinoids: a new approach for pain control?

Purpose Of Review: To analyze available data related to the use of cannabinoids in medicine, with a special focus on pain management in cancer. The use of cannabis for medical purposes is growing but there are still numerous questions to be solved: effectiveness, safety, and specific indications.

Recent Findings: There is considerable variation between countries in the approaches taken, reflecting a variety of historical and cultural factors and despite few randomized controlled studies using natural cannabinoids, there is a trend to state that the use of cannabis should be taken seriously as a potential treatment of cancer-related pain.

Pain control in thoracic oncology.

This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert.

A little help from steroids in oncology.

Steroids are widely used in oncology and have been demonstrated to possess an anticancer effect or antiswelling effect. They are considered to improve refractory symptoms such as dyspnea or gastrointestinal (GI) obstruction. However, their roles in nonspecific indications are not well proved.

Supportive/palliative care in cancer patients: quo vadis?

Supportive care in cancer has become a paradigm for the treatment in oncology. Now, we have guidelines and active research in that field, making this area of clinical oncology both authoritative and rapidly progressing.The present paper focuses on the clinical experience of a group involved with supportive care in cancer patients for more than 25 years; it is hoped that our considerations might be helpful for further developments in this concept.

End-of-life sedation: is there an alternative?

Purpose Of Review: To evaluate the place and the usefulness of sedation in medical practice at the end of life.

Recent Findings: Continuous sedation is an acknowledged medical practice for the management of refractory symptoms at the end of life. Guidelines and recommendations have been proposed in palliative care.

Narrative ethics in the field of oncology.

Purpose Of Review: To evaluate the application of narrative within medical practice. Illness like cancer constitutes a biographical disruption that occurs several times during the disease, from diagnosis to complications and treatments. This review analyzes the interest of narrative ethics in medicine with a focus on cancer.

Psychological interventions to reduce pain in patients with cancer.

Purpose Of Review: To review relevant studies about psychological interventions among patients with cancer pain.

Recent Findings: We used MEDLINE as a source of studies on psychological interventions between January 2012 and December 2012. Most studies were randomized, but there was no homogeneity in terms of psychological intervention types or pain evaluation.

Intrathecal Trastuzumab Treatment of the Neoplastic Meningitis due to Breast Cancer: A Case Report and Review of the Literature.

We report the case of a 65-year-old woman, diagnosed with a breast cancer human epidermal growth factor receptor (HER2) previously negative, who developed leptomeningeal carcinomatosis and was treated with intrathecal (IT) trastuzumab (TST). After five doses of IT trastuzumab, at escalading doses, once weekly, the patient's neurological status stabilised, and that result was maintained for two months. There is evidence in the literature that breast cancer receptor status may change over time, and when it occurs, it may modify the therapeutical approach.

An open-label extension study to investigate the long-term safety and tolerability of THC/CBD oromucosal spray and oromucosal THC spray in patients with terminal cancer-related pain refractory to strong opioid analgesics.

Context: Chronic pain in patients with advanced cancer poses a serious clinical challenge. The Δ9-tetrahydrocannabinol (THC)/cannabidiol (CBD) oromucosal spray (U.S.

Breakthrough pain: progress in management.

Purpose Of Review: To present recent developments in the treatment of breakthrough pain (BTP) in cancer, we reviewed the literature with a special focus on last publications using Medline.

Recent Findings: BTP is distinguished from other pain syndromes because of its unique physiopathology, clinical and socio-economic importance and treatment considerations. Despite medical awareness, BTP remains underdiagnosed and therefore undertreated.

Brain metastases in HER2-positive breast cancer: the evolving role of lapatinib.

Due to improvements in diagnosis and systemic therapy, brain metastases are an increasingly common cause of morbidity and mortality for patients with advanced breast cancer. The incidence of symptomatic brain metastases among women with metastatic breast cancer ranges from 10% to 16%. The HER2 receptor, which is overexpressed in approximately 25% of all breast cancers, is an important risk factor for the development of central nervous system metastases.

Multicenter, double-blind, randomized, placebo-controlled, parallel-group study of the efficacy, safety, and tolerability of THC:CBD extract and THC extract in patients with intractable cancer-related pain.

This study compared the efficacy of a tetrahydrocannabinol:cannabidiol (THC:CBD) extract, a nonopioid analgesic endocannabinoid system modulator, and a THC extract, with placebo, in relieving pain in patients with advanced cancer. In total, 177 patients with cancer pain, who experienced inadequate analgesia despite chronic opioid dosing, entered a two-week, multicenter, double-blind, randomized, placebo-controlled, parallel-group trial. Patients were randomized to THC:CBD extract (n = 60), THC extract (n = 58), or placebo (n = 59).

Multicenter phase II study of lapatinib in patients with brain metastases from HER2-positive breast cancer.

Purpose: Brain metastases develop in one third of patients with advanced HER2+ breast cancer. Effective therapy for patients with central nervous system (CNS) progression after cranial radiation is extremely limited and represents a major clinical challenge. Lapatinib, an epidermal growth factor receptor/HER2 inhibitor, was associated with regressions of CNS lesions in a small phase 2 trial.

Imatinib mesylate in a patient with metastatic disease originating from a dermatofibrosarcoma protuberans of the scalp.

Dermatofibrosarcoma protuberans is a soft-tissue tumor that may recur locally and rarely causes metastases to vital organs. Dermatofibrosarcoma protuberans has specific chromosomal abnormalities involving the platelet-derived growth factor beta-chain locus that may render these tumors responsive to targeted therapy with the tyrosine kinase inhibitor imatinib mesylate. A patient with locally recurrent and metastatic dermatofibrosarcoma protuberans who had already undergone surgery 22 times was initially treated with imatinib mesylate 400 mg/day.

Successful use of ketamine for intractable cancer pain.

Unlabelled: 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.