Pharmacotherapy of pain in cancer patients – recommendations of the Polish Association for the Study of Pain, Polish Society of Palliative Medicine, Polish Society of Oncology, Polish Society of Family Medicine, Polish Society of Anaesthesiology and Intensive Therapy and Association of Polish Surgeons

• Authors: Jerzy Wordliczek , Aleksandra Kotlińska-Lemieszek , Wojciech Leppert , Jarosław Woroń , Jan Dobrogowski , Małgorzata Krajnik , Anna Przeklasa-Muszyńska , Jacek Jassem , Jarosław Drobnik , Anna Wrzosek , Marcin Janecki , Jadwiga Pyszkowska , Magdalena Kocot-Kępska , Renata Zajączkowska , Iwona Filipczak-Bryniarska , Krystyna Boczar , Joanna Jakowicka-Wordliczek , Małgorzata Malec-Milewska , Andrzej Kübler , Marek Suchorzewski , Sylwester Mordarski , Adam Dziki , Krzysztof Paśnik

Abstracts

EN

Guidelines for the pharmacotherapy of pain in cancer patients were developed by a group of 21 experts of the Polish Association for the Study of Pain, Polish Society of Palliative Medicine, Polish Society of Oncology, Polish Society of Family Medicine, Polish Society of Anaesthesiology and Intensive Therapy and Association of Polish Surgeons. During a series of meetings, the experts carried out an overview of the available literature on the treatment of pain in cancer patients, paying particular attention to systematic reviews and more recent randomized studies not included in the reviews. The search was performed in the EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trials databases using such keywords as “pain”, “cancer”, “pharmacotherapy”, “analgesics”, and similar. The overviewed articles included studies of pathomechanisms of pain in cancer patients, methods for the assessment of pain in cancer patients, and drugs used in the pharmacotherapy of pain in cancer patients, including non-opioid analgesics (paracetamol, metamizole, non-steroidal anti-inflammatory drugs), opioids (strong and weak), coanalgesics (glucocorticosteroids, α2-adrenergic receptor agonists, NMDA receptor antagonists, antidepressants, anticonvulsants, topical medications) as well as drugs used to reduce the adverse effects of the analgesic treatment and symptoms other than pain in patients subjected to opioid treatment. The principles of opioid rotation and the management of patients with opioidophobia were discussed and recommendations for the management of opioid-induced hyperalgesia were presented. Drugs used in different types of pain experienced by cancer patients, including neuropathic pain, visceral pain, bone pain, and breakthrough pain, were included in the overview. Most common interactions of drugs used in the pharmacotherapy of pain in cancer patients as well as the principles for the management of crisis situations. In the final part of the recommendations, the issues of pain and care in dying patients are discussed. Recommendations are addressed to physicians of different specialties involved in the diagnostics and treatment of cancer in their daily practice. It is the hope of the experts who took part in the development of these recommendations that the recommendations would become helpful in everyday medical practice and thus contribute to the improvement in the quality of care and the efficacy of pain treatment in this group of patients.

Keywords

EN

pharmacotherapy; pain; cancer patients pain; recommendations; oncology; palliative medicine; anesthesiology; adverse effects; drug interactions

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2018
• Volume: 90(4)
• Pages: 55-84

Dates

published

2018-08-21

Contributors

author

Jerzy Wordliczek

author

Aleksandra Kotlińska-Lemieszek

author

Wojciech Leppert

author

Jarosław Woroń

author

Jan Dobrogowski

author

Małgorzata Krajnik

author

Anna Przeklasa-Muszyńska

author

Jacek Jassem

author

Jarosław Drobnik

author

Anna Wrzosek

author

Marcin Janecki

author

Jadwiga Pyszkowska

author

Magdalena Kocot-Kępska

author

Renata Zajączkowska

author

Iwona Filipczak-Bryniarska

author

Krystyna Boczar

author

Joanna Jakowicka-Wordliczek

author

Małgorzata Malec-Milewska

author

Andrzej Kübler

author

Marek Suchorzewski

author

Sylwester Mordarski

author

Adam Dziki

author

Krzysztof Paśnik

Identifiers

DOI

10.5604/01.3001.0012.2904