Cancer Pain Management: Principles and Practice

Author: Winston C. V. Parris
Publisher:
Publish Date: 2003-01-01
Features: Starting from the historical background and etiology of cancer pain, it describes the current epidemiological situation with the latest data and discusses existing and new cancer pain control methods. Preface Cancer Pain Therapy: Principles and Practice is a milestone in the history of cancer pain treatment, specifically addressing the unpredictable pain caused by cancer. Although pain has been a human suffering since ancient times, it has always been a common reason for seeking medical attention. Chronic pain and a high quality of life are incompatible. It wasn’t until the 19th century that we had the ability to use general anesthesia to control pain. The editors of this book come from the field of anesthesia, and many of the contributors are also colleagues in the field of anesthesia. The general inadequacy of cancer pain treatment has prompted the timely publication of this book. Inappropriate cancer pain therapies have undermined doctors' confidence in treating cancer pain and have caused unimaginable suffering for patients and their families. Doctors who adhere to the principles of this book can alleviate the pain of cancer patients. This book is very comprehensive and indeed should be, as cancer pain involves many medical disciplines. To address this, the authors and contributors faced a great challenge in writing this book. Facing the challenge, they diligently took a step forward and produced a high-quality work. The book consists of 48 chapters and 61 contributors. The writing is fluent, starting from the historical background and etiology of cancer pain, describing the current epidemiological situation of adult and pediatric pain with the latest data, and discussing existing and new cancer pain control methods. It includes sustained-release opioid formulations for pain control, intrathecal and epidural use of opioids, nerve block therapy, interventional techniques for pain treatment, nerve blocks for pain relief, antinociceptive techniques, morphine, invasive pain relief techniques, and neurolysis. A consensus feature of the book is its dedication to the psychological needs of cancer patients, discussing the role of home care and outpatient support. It also addresses the roles of nurses, social workers, nutritionists, and other professionals. Additionally, the activities of patient organizations and supporters are listed. The final chapter of the book reflects the compassion and personality of the authors and contributors. Some chapters also discuss the relationship between spirituality and suffering, ethical issues, and government guidelines for cancer pain management. Since cancer and its related pain affect all medical principles, the writing of this book was complex. However, Dr. Winston C. V. Parris and his contributors bravely faced the challenge and completed a meaningful and high-quality work. All healthcare institutions treating cancer pain should thank such a masterpiece. Preface Cancer remains one of the diseases that are a sentence to death. Traditionally, the term cancer carries this ominous connotation for two reasons: first, most cancer patients die soon after diagnosis, and second, most cancer patients know they will suffer pain before or during death. Cancer treatment has made significant progress, and in fact, almost everyone knows someone who has cancer but is still alive, and many are familiar with cancer patients and their pain, and understand that their pain has been satisfactorily controlled. This is very encouraging. Although the treatment of cancer pain is not yet ideal, its level has rapidly improved due to the efforts of the late John Bonica. John Bonica warned authorities, nations, and international societies about the inappropriate treatment of cancer pain. It is unrealistic to say that John Bonica’s warnings have been noticed, in fact, they are far from the reality. There are many reasons for this inadequacy, one of the main reasons being the lack of enthusiasm and confidence in introducing general pain and cancer pain treatment to healthcare educators, especially in university and graduate medical nursing courses and training programs. Unfortunately, today, in most medical research institutions in the United States, almost no time is allocated to medical research on pain. Therefore, the inappropriate treatment of cancer patients is not surprising, largely due to the lack of basic knowledge of cancer pain treatment among healthcare providers. The main purpose of this book is to disseminate information about cancer pain and its treatment. The discussion of controversial issues is also my hope to spark the interest of a broad readership (regardless of their familiarity with the field) in learning about cancer pain and its subtle differences. The book’s dedication to presenting multidisciplinary knowledge about cancer pain is one of its key features. The invited experts come from different disciplines and countries, with diverse perspectives, resulting in a work that is diverse, broad, and clear. To achieve this goal, the selected authors were chosen not only for their specialized expertise in a particular field but also for their commitment and passion for improving the treatment of cancer pain. A review of basic science, the pathophysiology of cancer pain, and clinical examinations of cancer pain patients provides a solid foundation for the treatment and evaluation of these patients. Some authors have made significant contributions and expressed their views clearly and confidently, preparing physicians who wish to become cancer pain specialists for this complex task. Therefore, I hope we succeed in inspiring readers to expand their knowledge and seek more information about the various and nuanced treatments for cancer pain. Physicians and other medical experts have a noble profession, and possessing the knowledge and ability to treat patients is both noble and honorable. Treating patients' cancer pain is even more admirable. When treatment is successful, most patients are very grateful. Gratitude is repaid to doctors, nurses, and other healthcare providers. With the reform of the healthcare system and the increasing competition in management, the individuality of healthcare is fading, and the interaction between patients and doctors is becoming more socialized. Fragmented Chapter 1 Historical Review Anne Marie McKenzie and Winston C. V. Parris Pain is a sensation, but it is not just a reaction to injury, because it is often associated with emotions and influenced by the environment at the time. People's understanding of pain, its origins, and its treatment has undergone several major shifts. Until recently, pain gradually shifted from a nearly mystical philosophical concept to a physiological response supported by scientific experimentation. For example, in the past, religious and superstitious views held that pain was a punishment from God, and people should endure it without treatment. According to Stoic philosophy, enduring pain was a virtue, and at one time, gout was even considered a sign of wealth and status. [1] Of course, because pain has certain predictive value, doctors in the emergency room often do not rush to give patients pain relief. For example, acute abdominal pain may indicate a possible acute abdomen, and acute back pain may also be caused by metastatic tumors. Although research on pain continues to deepen, ideal treatment methods are still lacking, especially for chronic pain. Despite the rapid advancement of various treatment techniques, most advanced cancer patients still suffer from severe pain. [2] It is encouraging that many organizations dedicated to pain research have emerged in the United States and around the world, and significant progress has been made in the pharmacology of cancer pain treatment. Ancient beliefs generally considered pain to be caused by injury or by abnormal disease processes or growths in internal organs, bones, or nerves. In ancient times, pain caused by trauma, such as injuries in war, did not arouse much curiosity; but pain caused by internal diseases was given a mystical connotation. [3,4] In tribal societies, pain was believed to originate from external invasions. Pain was seen as a curse from God, and these curses entered the body through various means, and the methods used by shamans or healers to treat these painful syndromes also depended on the route of entry. [4–7] In New Guinea, people believed that curses entered the body like arrows and spears, causing conscious pain. In Egypt, the left nostril was considered the most common entry point. [3] The Ebers and Berlin papyri record methods to expel curses through sneezing, sweating, vomiting, urination, or even using trephination to treat headaches, similar to the modern use of transcutaneous electrical nerve stimulation. [7] Shamans could also draw curses out of wounds and then treat the wounds with special powders. [4,5,7] Ancient Egyptians placed an electrically charged fish from the Nile on wounds to relieve pain, similar to the use of transcutaneous electrical nerve stimulation today. [7] The word "pain" comes from the Latin "poena," meaning "punishment," while the word "patient" comes from the Latin "patior," meaning "to suffer pain." [7,8] People sought to appease God's anger through sacrifices to alleviate the pain of God's punishment. Ancient texts also describe the treatment of children's pain, including wearing amulets and drinking so-called holy water. Different pain relief methods were used for different types of pain, such as wearing an amulet made from a dead person's tooth to treat toothache (Omnibonus Ferrarius, 1577). [9] There are also records of using opium to treat children's pain.