Pain in the Cancer Patient

Pain is unfortunately not an early symptom in neoplastic diseases. When it occurs, however, as it so often does in the advanced stages of the disease, then it can be particularly severe. Many physicians are not able to treat such pain efficiently with the standard methods familiar to them. Even in the oncological clinic, it is common for cancer patients not to receive adequate treatment of their pain; the therapeutic efforts are directed principally at the cancer, the pain often being neglected. This book fills a gap in the literature and should enhance the awareness of pain of all those who deal with cancer patients. For the patient, the symptoms of the disease are usually the direct cause of suffering, and pain is often the most severe symptom. The pain may be potentiated by knowledge of the threat posed by the cancer, or may itself considerably increase the patients existing anxiety. Thus there is a vicious circle of pain and psychological factors which will reduce the patient to a state of despair and distress. It is, therefore, obvious that efficient pain therapy is of utmost signi ficance to the patient, who will judge the doctor's ability to provide medical assistance according to the degree of pain relief achieved. The patient's quality of life will also depend critically on the relief obtained.

Inhalt
Guidelines for Therapy of Pain in Cancer Patients.- Management of Cancer Pain.- The Telos and Ethos of Pain and Suffering.- Pathological Anatomy of Cancer Pain.- Neurophysiological Mechanisms of Cancer Pain.- Pharmacology of the Primary Nociceptive Neuron.- Frequency of Pain in Patients with Cancer.- Clinical Pain Syndromes in Cancer Patients and Their Causes.- Analysis of Cancer Pain by the Neurologist.- Pain in the Cancer Patient as a Consequence of Therapy (Surgery, Radiotherapy, Chemotherapy).- Control of Cancer Pain with Analgesics Acting in the Central Nervous System.- Epidural Opiates for the Treatment of Cancer Pain.- Opiates and Respiratory Function in Advanced Cancer.- The Use of Psychotropic Drugs in the Treatment of Cancer Pain.- Local Anesthetics in the Treatment of Cancer Pain.- Treatment of Cancer Pain with Neurolytic Agents.- Neurosurgical Treatment of Cancer Pain.- Orthopedic Surgery for Management of Tumor Pain.- Chemotherapy for the Treatment of Cancer Pain.- Calcitonin: Analgesic Effects.- Treatment of Terminal Pain in Cancer Patients by Means of Iontophoresis of Vinca Alkaloids.- Radiotherapy of Cancer Pain.- Psychological Treatment Modalities for Pain in Cancer Patients.- Hospice Care: The Treatment of Pain in Advanced Cancer.