Although the control
of the symptoms of cancer is not typically thought of as a
treatment directed at the cancer, it is an important determinant
of the quality of life of cancer patients, and plays an
important role in the decision whether the patient is able to
undergo other treatments. Although all practicing doctors have
the therapeutic skills to control pain, nausea, vomiting,
diarrhea, hemorrhage and other common problems in cancer
patients, the multidisciplinary specialty of palliative care has
arisen specifically in response to the symptom control needs of
this group of patients.
Pain medication, such as morphine and oxycodone, and antiemetics,
drugs to suppress nausea and vomiting, are very commonly used in
patients with cancer-related symptoms. Improved antiemetics such
as ondansetron and analogues, as well as aprepitant have made
aggressive treatments much more feasible in cancer patients.
Chronic pain due to cancer is almost always associated with
continuing tissue damage due to the disease process or the
treatment (i.e. surgery, radiation, chemotherapy). Although
there is always a role for environmental factors and affective
disturbances in the genesis of pain behaviors, these are not
usually the predominant etiologic factors in patients with
cancer pain. Furthermore, many patients with severe pain
associated with cancer are nearing the end of their lives and
palliative therapies are required. Issues such as social stigma
of using opioids, work and functional status, and health care
consumption are not likely to be important in the overall case
management. Hence, the typical strategy for cancer pain
management is to get the patient as comfortable as possible
using opioids and other medications, surgery, and physical
measures. Doctors have been reluctant to prescribe narcotics for
pain in terminal cancer patients, for fear of contributing to
addiction or suppressing respiratory function. The palliative
care movement, a more recent offshoot of the hospice movement,
has engendered more widespread support for preemptive pain
treatment for cancer patients.
Treatment
Complementary and alternative >>
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Cancer
Classification
1. Nomenclature
2. Adult cancers
3. Childhood cancers
Signs and symptoms
Diagnosis
1. Investigation
2. Biopsy
Treatment
1. Surgery
2. Radiation therapy
3. Chemotherapy
4. Targeted therapies
5. Immunotherapy
6. Hormonal therapy
7. Symptom control
8. Complementary and alternative
9. Treatment trials
Prognosis
1. Emotional impact
Causes
1. Chemical carcinogens
2. Ionizing radiation &
Infectious diseases
3. Hormonal imbalances
& Immune system dysfunction
4. Heredity & Other causes
Pathophysiology
1. Epigenetics
2. Oncogenes
3. Tumor suppressor genes
4. Cancer cell biology
4.1 Clonal evolution
4.2 Biological properties of cancer cells
Prevention
1. Modifiable ("lifestyle") risk factors
2. Diet
3. Vitamins
4. Chemoprevention
5. Genetic testing
6. Vaccination
7. Screening
Epidemiology
History
Research |
