Skip to main content

Pain Management for Sarcoma Patients

  • Chapter
  • First Online:
Sarcoma
  • 1301 Accesses

Abstract

Fear is inevitable when one faces the threat of pain. When this feeling arises, it puts the patient’s treatment course in jeopardy. The undertreatment of cancer pain has been a global epidemic for a number of years. At the time of their diagnosis, approximately 30–50% of cancer patients have experienced pain. This percentage rises to 50–70% of patients during their cancer treatment, while 65–90% of patients with advanced cancer are burdened with inadequate control of their pain. Consequences of unrelieved pain include loss of autonomy, social isolation, suffering, psychological distress, and the diminished ability to comply with the cancer treatment. This chapter will discuss the causes of and treatment of cancer pain along with a discussion of phantom limb pain.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 139.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 179.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 249.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Cancer facts and figures. American Cancer Society; 1995.

    Google Scholar 

  2. Cleeland CS, Gonin R, Hatfield AK. Pain and its treatment in outpatients with metastatic cancer. N Engl J Med. 1994;330:592–6.

    Article  CAS  PubMed  Google Scholar 

  3. Zhukovsky DS, Gorowski E, Hausdorff J, Napolitano B, Lesser M. Unmet analgesic needs in cancer patients. J Pain Symptom Manage. 1995;10:113–9.

    Article  CAS  PubMed  Google Scholar 

  4. Christo PJ, Mazloomdoost D. Cancer pain and analgesia. Ann N Y Acad Sci. 2008;1138:278–98.

    Article  CAS  PubMed  Google Scholar 

  5. Coyle N, Adelhardt J, Foley KM, Portenoy RK. Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manage. 1990;5:83–93.

    Article  CAS  PubMed  Google Scholar 

  6. Portenoy RK, Miransky J, Thaler HT. Pain in ambulatory patients with lung or colon cancer: prevalence, characteristics, and effect. Cancer. 1992;70:1616–24.

    Article  CAS  PubMed  Google Scholar 

  7. Grond S, Zech D, Diefenbach C, Bischoff A. Prevalence and pattern of symptoms in patients with cancer pain: a prospective evaluation of 1635 cancer patients referred to a pain clinic. J Pain Symptom Manage. 1994;9:372–82.

    Article  CAS  PubMed  Google Scholar 

  8. Bonica J. The management of pain. 2nd ed. Philadelphia: Lea &Febiger; 1990. p. 1484–514.

    Google Scholar 

  9. McQuay H. Opioids in pain management. Lancet. 1999;353:2229–32.

    Google Scholar 

  10. Portenoy RK, Lesage P. Management of cancer pain. Lancet. 1999;353:1695–700.

    Article  CAS  PubMed  Google Scholar 

  11. Baltic TE, Whedon MB, Ahles TA, Fancilullo G. Improving pain relief in a rural cancer center. Cancer Pract. 2002;10:S39–44.

    Article  PubMed  Google Scholar 

  12. Lasch K. Why study pain? A qualitative analysis of medical and nursing faculty and students’ knowledge of and attitudes to cancer pain management. J Palliat Med. 2002;5:57–71.

    Article  CAS  PubMed  Google Scholar 

  13. Payne R. Chronic pain: challenges in the assessment and management of cancer pain. J Pain Symptom Manage. 2000;19:S12–5.

    Article  CAS  PubMed  Google Scholar 

  14. Ward S. Patient education in pain control. Support Care Cancer. 2001;9:148–55.

    Article  CAS  PubMed  Google Scholar 

  15. Gunnarsdottir S. Patient-related barriers to pain management: the Barriers Questionnaire II. Pain. 2002;99:385–96.

    Article  PubMed  Google Scholar 

  16. Ward S, Gatwood J. Concerns about reporting pain and using analgesics. A comparison of persons with and without cancer. Pain. 1993;52:319–24.

    Article  CAS  PubMed  Google Scholar 

  17. Ward SE, Goldberg V, Miller-McCauley V. Patient-related barriers to management of persons with and without cancer. Pain. 1993;52:319–24.

    Article  CAS  PubMed  Google Scholar 

  18. Cherny NI, Portenoy RK. Cancer pain: principles of assessment and syndromes. In: Wall PD, Melzck R, editors. Textbook of pain. 4th ed. Edinburg: Churchill Livingstone; 1999.

    Google Scholar 

  19. Dy SM. Evidence-based approaches to pain in advanced cancer. Cancer J. 2010;16:500–6.

    Article  PubMed  Google Scholar 

  20. Vorobeychik Y, Gordin V, Mao J, Chen L. Combination therapy for neuropathic pain: a review of current evidence. CNS Drugs. 2011;25:1023–34.

    Article  CAS  PubMed  Google Scholar 

  21. Vadalouca A, Raptis E, Moka E, Zis P, Sykioti P, Siafaka I. Pharmacological treatment of neuropathic cancer pain: a comprehensive review of the current literature. Pain Pract. 2012;12:219–51.

    Article  PubMed  Google Scholar 

  22. Shaiova L. Difficult pain syndrome: bone pain, visceral pain, and neuropathic pain. Cancer J. 2006;12:330–40.

    Article  CAS  PubMed  Google Scholar 

  23. Cherny NI, Portenoy RK. The management of cancer pain. CA Cancer J Clin. 1994;44:262–303.

    Article  Google Scholar 

  24. Cleeland CS. The impact of pain on the patient with cancer. Cancer. 1984;54:2635–41.

    Article  CAS  PubMed  Google Scholar 

  25. Fishman B, Pasternak S, Wallenstein SL, House RW, Holland JC, Foley KM. The Memorial Pain Assessment Card: a valid instrument for the evaluation of cancer pain. Cancer. 1987;60:1151–8.

    Article  CAS  PubMed  Google Scholar 

  26. Au E, Loprinzi CL, Dhodapkar M. Regular use of a verbal pain scale improves the understanding of oncology inpatient pain intensity. J Clin Oncol. 1994;12:2751–5.

    Article  CAS  PubMed  Google Scholar 

  27. Ferrer-Brechner T. The management of pain associated with malignancy. Semin Anesth. 1985;4:313–22.

    Google Scholar 

  28. Schug SA, Zech D, Dorr U. Cancer pain management according to WHO analgesic guidelines. J Symptom Manage. 1994;9:372–82.

    Article  Google Scholar 

  29. Ventafridda V, Caraceni A, Gamba A. Field-testing of the WHO guidelines for cancer pain relief: summary report of demonstration projects. In: Proceedings of the second international congress of cancer pain, vol. 16. 1990. p. 451–64.

    Google Scholar 

  30. Jacox A, Carr DB, Payne R, Management of cancer pain: clinical practice guideline. No. 9. Rockville: Agency for Health Care Policy and Research 1994 (AHCPR publication no 94–0592).

    Google Scholar 

  31. Cherny NI, Portenoy RK. The management of cancer pain. Cancer J Clin. 1994;44:263–303.

    Article  CAS  Google Scholar 

  32. Levy MH. Pharmacologic management of cancer pain. Semin Oncol. 1994;21:718–39.

    CAS  PubMed  Google Scholar 

  33. Principles of analgesic use in the treatment of acute and cancer pain. American Pain Society; 1992.

    Google Scholar 

  34. Twycross R. Pain relief in advanced cancer. London: Churchill Livingstone; 1994.

    Google Scholar 

  35. Bonica JJ. History of pain concepts and pain therapy. Mt Sinai J Med. 1991;58(3):191–202.

    CAS  PubMed  Google Scholar 

  36. Malmberg AB, Yaksh TL. Hyperalgesia medicated by spinal glutamate and substance P receptor blocked by spinal cyclooxygenase inhibition. Science. 1992;257:1276–9.

    Article  CAS  PubMed  Google Scholar 

  37. Willer JC, De Broucker T, Bussel B. Central analgesic effect of ketoprofen in humans: electrophysiological evidence for a supraspinal mechanism in a double-blind and cross-over study. Pain. 1989;38:1–7.

    Article  CAS  PubMed  Google Scholar 

  38. Watson AC, Brookes ST, Kirwan JR, Faulkner A. Non-aspirin, non-steroidal anti-inflammatory drugs for osteoarthritis of the knee. Cochrane Database Syst Rev. 2000;(2).

    Google Scholar 

  39. Vane JR. Inhibition of prostaglandin synthesis as a mechanism of action for aspirin-like drugs. Nat New Biol. 1971;231:232–5.

    Article  CAS  PubMed  Google Scholar 

  40. Simon LS, Lanza FL, Lipsky PT, et al. Efficacy and safety in two placebo-controlled trials in osteoarthritis and rheumatoid arthritis, and studies of gastrointestinal and platelet effects. Arthritis Rheum. 1998;9:1591–602.

    Article  Google Scholar 

  41. Stuart MJ, Murphy S, Oski FA, Evans AE, Donaldson MH, Gardner FH. Platelet function in recipients of platelets from donors ingesting aspirin. N Engl J Med. 1972;287:1105–9.

    Article  CAS  PubMed  Google Scholar 

  42. Sunshine A. New clinical experience with tramadol. Drugs. 1994;47(Suppl 1):8–18.

    Article  PubMed  Google Scholar 

  43. Wilder-Smith CH, Schmike J, Osterwakder B, Senn HJ. Oral tramadol, a mu-opioid agonist and monoamine reuptake-blocker, and morphine for strong cancer-related pain. Ann Oncol. 1994;5:141–6.

    Article  CAS  PubMed  Google Scholar 

  44. Babul N. Efficacy and safety of extended-release, once-daily tramadol in chronic pain: a randomized 12-week clinical trial in osteoarthritis of the knee. J Pain Symptom Manage. 2004;28:497–504.

    Article  CAS  Google Scholar 

  45. Arbaiza D, Vidal O. Tramadol in the treatment of neuropathic cancer pain. Clin Drug Investig. 2007;27(1):75–83.

    Article  CAS  PubMed  Google Scholar 

  46. Eichelbaum M, Evert B. Influence of pharmacogenetics on drug disposition and response. Clin Exp Pharmacol Physiol. 1996;23:983–5.

    Article  CAS  PubMed  Google Scholar 

  47. Davis T, Mellar P. Hydrocodone. Opioids for cancer pain. Oxford: Oxford University Press; 2007. p. 59–68.

    Google Scholar 

  48. Kirvela M. The pharmacokinetics of oxycodone in uremic patients undergoing renal transplantation. J Clin Anesth. 1996;8:13–8.

    Article  CAS  PubMed  Google Scholar 

  49. Bruera E. Randomized, double-blind, cross-over trial comparing safety and efficacy of oral controlled-release oxycodone with controlled-release morphine in patients with cancer pain. J Clin Oncol. 1998;16:3222–9.

    Article  CAS  PubMed  Google Scholar 

  50. Heisknen T, Kalso E. Controlled-release oxycodone and morphine in cancer related pain. Pain. 1997;73:37–45.

    Article  Google Scholar 

  51. Mucci-LoRosso P. Controlled-release oxycodone compared with controlled-release morphine in the treatment of cancer pain: a randomized, double-blind, parallel-group study. Eur J Pain. 1998;2:239–349.

    Article  Google Scholar 

  52. Ananthan S. Identification of opioid ligands possessing mixed micro agonist/delta antagonist activity among pyridomorphinans derived from naloxone, oxymorphone, and hydromorphone. J Med Chem. 2004;47:1400–12.

    Article  CAS  PubMed  Google Scholar 

  53. Sloan P, Slatkin N, Ahdieh H. Effectiveness and safety of oral extended-release oxymorphone for the treatment of cancer pain: a pilot study. Support Care Cancer. 2005;13:57–65.

    Article  PubMed  Google Scholar 

  54. Adams MA, Ahdieh H. Single and multiple dose pharmacokinetic and dose proportionality study of oxymorphone immediate release tablets. Drugs R D. 2005;6:91–9.

    Article  CAS  PubMed  Google Scholar 

  55. Gutstein HB, Huda A. Goodman and Gilman’s the pharmacological basis of therapeutics. 11th ed. McGraw Hill, New York 2006. p. 571.

    Google Scholar 

  56. Ahmedzai S, Brooks D. Transdermal fentanyl versus sustained-release oral morphine in cancer pain: preference, efficacy, and quality of life. The TTS-Fentanyl Comparative Trial Group. J Pain Symptom Manage. 1997;13:254–61.

    Article  CAS  PubMed  Google Scholar 

  57. Donner B. Long-term treatment of cancer pain with transdermal fentanyl. J Pain Symptom Manage. 1998;15:168–75.

    Article  CAS  PubMed  Google Scholar 

  58. Radbruch L. Transdermal fentanyl for the management of cancer pain: a survey of 1005 patients. Palliat Med. 2001;15:309–21.

    Article  CAS  PubMed  Google Scholar 

  59. Camps C, Cassinello J, Jara C, et al. Tolerability and effectivity of oral transmucosal fentanyl citrate in the long-term treatment of irruptive pain in oncology patients: ECODIR study. Clin Transl Oncol. 2005;7:205–12.

    Article  Google Scholar 

  60. Bulka A. Reduced tolerance to the anti-hyperalgesic effect of methadone in comparison to morphine in a rat model of mononeuropathy. Pain. 2002;95:103–9.

    Article  CAS  PubMed  Google Scholar 

  61. Bulka A, Weisenfield-Hallin Z, Xu XJ. Differential antinociception by morphine and methadone in two sub-strains of Sprague-Dawley rats and its potentiation by dextromethorphan. Brain Res. 2002;942:95–100.

    Article  CAS  PubMed  Google Scholar 

  62. Davis M, Walsh D. Methadone for relief of cancer pain: a review of pharmacokinetics pharmacodynamics, drug interactions and protocols of administration. Support Care Cancer. 2001;9:73–83.

    Article  CAS  PubMed  Google Scholar 

  63. Mercadante S, Casuccio A, Fulfaro F, et al. Switching from morphine to methadone to improve analgesia and tolerability in cancer patients: a prospective study. J Clin Oncol. 2001;19:2898–904.

    Article  CAS  PubMed  Google Scholar 

  64. Grochow L. Does intravenous methadone provide longer lasting analgesia than intravenous morphine? A randomized, double-blind study. Pain. 1989;38:151–7.

    Article  CAS  PubMed  Google Scholar 

  65. Reddy SF, Fisch M, Bruera E. Oral methadone for cancer pain: no indication of Q-T interval prolongation or torsades de pointes. J Pain Symptom Manage. 2004;28:301–3.

    Article  PubMed  Google Scholar 

  66. Roden M. Drug-induced prolongation of the QT interval. N Engl J Med. 2004;350:1015–22.

    Google Scholar 

  67. Kreek MJ, Gutjahr CL. Drug interactions with methadone. Ann N Y Acad Sci. 1976;281:350–70.

    Article  CAS  PubMed  Google Scholar 

  68. Terlinden R, Ossig J, Fliegert F, Lange C, Gohler K. Absorption, metabolism, and excretion of 14C-labeled tapentadol HCl in healthy male subjects. Eur J Drug Metab Pharacokinet. 2007;32:163–9.

    Article  CAS  Google Scholar 

  69. Hartrick C, Van Hove I, Stegmann JU, Oh C, Upmalis D. Efficacy and tolerability of tapentadol immediate release and oxycodone HCl immediate release in patients awaiting primary joint replacement surgery for end-stage joint disease: a 10-day, phase III, randomized, double-blind, active- and placebo-controlled study. Clin Ther. 2009;31:260–71.

    Article  CAS  PubMed  Google Scholar 

  70. Weschules DJ, Bain KT, Reifsnyder J, et al. Toward evidence-based prescribing at end of life: a comparative analysis of sustained-release morphine, oxycodone, and transdermal fentanyl, with pain, constipation, and caregiver interaction outcomes in hospice patients. Pain Med. 2006;7:320–9.

    Article  PubMed  Google Scholar 

  71. Ferrell BR, Griffith H. Cost issues related to pain management: report from the Cancer Pain Panel of the Agency for Health Care Policy and Research. J Pain Symptom Manage. 1994;9:221–34.

    Article  CAS  PubMed  Google Scholar 

  72. Kalso E, Vainio A. Morphine and oxycodone hydrochloride in the management of cancer pain. Clin Pharmacol Ther. 1990;47:639–46.

    Article  CAS  PubMed  Google Scholar 

  73. Bruera EB, Pereira J, Watanabe S. Systematic opioid therapy for chronic cancer pain: practical guidelines for converting drugs and routes. Cancer. 1996;78:852–7.

    Article  CAS  PubMed  Google Scholar 

  74. Acute pain managements in infants, children, and adolescents: operative and medical procedures. In: US Dept of Health and Human Services. Rockville: Agency for Health Care Policy and Research; 1992.

    Google Scholar 

  75. Hershey L. Meperidine and central neurotoxicity. Ann Intern Med. 1983;55:425–9.

    Google Scholar 

  76. WHO. Cancer pain relief and palliative care. Geneva: WHO; 1996.

    Google Scholar 

  77. DuPen A, Shen D, Ersek M. Mechanisms of opioid induced tolerance and hyperesthesia. Pain Manag Nurs. 2007;8(3):113–21.

    Article  PubMed  Google Scholar 

  78. Mercadante S. The role of octreotide in palliative care. J Pain Symptom Manage. 1994;9:406–11.

    Article  CAS  PubMed  Google Scholar 

  79. Moulin DE, Iezzi A, Amireh R, Sharpe WK, Boyd D, Merksey H. Randomized trial of oral morphine for chronic non-cancer pain. Lancet. 1996;347:143–7.

    Article  CAS  PubMed  Google Scholar 

  80. Bruera E, Brenneis C, Paterson AH, MacDonald RN. Use of methylphenidate as an adjuvant to narcotic analgesics in patients with advanced cancer. J Pain Symptom Manage. 1994;9:3–6.

    Article  Google Scholar 

  81. Dahan A. Simultaneous measurement and integrated analysis of analgesia and respiration after an intravenous morphine infusion. Anesthesiology. 2004;101:1201–9.

    Article  CAS  PubMed  Google Scholar 

  82. McQuay H. Opioids in pain management. Lancet. 1999;353:2229–32.

    Article  CAS  PubMed  Google Scholar 

  83. Portenoy R. Chronic opioid therapy in nonmalignant pain. J Pain Symptom Manage. 1990;5(1 Suppl):S46–62.

    CAS  PubMed  Google Scholar 

  84. Sees KL, Clark HW. Opioid use in the treatment of chronic pain: assessment of addiction. J Pain Symptom Manage. 1993;8:257–64.

    Article  CAS  PubMed  Google Scholar 

  85. Macaluso C, Weinberg D, Foley K. Opioid abuse and misuse in a cancer pain population. J Pain Symptom Manage. 1998;3:S24.

    Article  Google Scholar 

  86. Passik SD, Kirsh KL, McDonald MV, Ahn S, et al. A pilot survey of aberrant drug-taking attitudes and behaviors in samples of cancer and AIDS patients. J Pain Symptom Manage. 2000;19:274–86.

    Article  CAS  PubMed  Google Scholar 

  87. Passik SD, Schreiber J, Kirsh KL. A chart review of the ordering of urine toxicology screen in a cancer center: do they influence pain management. J Pain Symptom Manage. 2000;19:44.

    Google Scholar 

  88. Schug SA, Zech D, Grond S, et al. A long term survey of morphine in cancer pain patients. J Pain Symptom Manage. 1992;7:259–66.

    Article  CAS  PubMed  Google Scholar 

  89. Portenoy RK, Foley KM, Inturrisi CE. The nature of opioid responsiveness and its implications for neuropathic pain: new hypothesis derived from studies of opioid infusions. Pain. 1990;43:273–86.

    Article  CAS  PubMed  Google Scholar 

  90. Mizoguchi H, Watanabe C, Yonezawa A, Sakkkurada S. New therapy for neuropathic pain. Int Rev Neurobiol. 2009;85:249–63.

    Article  CAS  PubMed  Google Scholar 

  91. McQuay HJ. A systematic review of antidepressants in neuropathic pain. Pain. 1996;68:217–27.

    Article  CAS  PubMed  Google Scholar 

  92. Sindrup SH, Jensen TS. Efficacy of pharmacological treatments of neuropathic pain: an update and effect related to mechanism of drug action. Pain. 1999;83:389–400.

    Article  CAS  PubMed  Google Scholar 

  93. Jefferies K. Treatment of neuropathic pain. Semin Neurol. 2010;30:425–32.

    Article  PubMed  Google Scholar 

  94. Watson CPN. Antidepressant drugs as adjuvant analgesics. J Pain Symptom Manage. 1994;9:392–405.

    Article  CAS  PubMed  Google Scholar 

  95. Potter WZ, Rudorfer MV, Manji H. The pharmacologic treatment of depression. N Engl J Med. 1991;325:633–42.

    Article  CAS  PubMed  Google Scholar 

  96. Vanken JH. Elucidation of pathophysiology and treatment of neuropathic pain. Cent Nerv Syst Agents Med Chem. 2012;12:304–14.

    Article  Google Scholar 

  97. Backonja M. Gabapentin for the symptomatic treatment of painful neuropathy in patients with diabetes mellitus: a randomized controlled trial. JAMA. 1998;280:1831–6.

    Article  CAS  PubMed  Google Scholar 

  98. Bennett MI, Simpson KH. Gabapentin in the treatment of neuropathic pain: a review. Palliat Med. 2004;18:5–11.

    Article  PubMed  Google Scholar 

  99. Rice AS, Maton S. Gabapentin in postherpetic neuralgia: a randomized, double-blind, placebo-controlled study. Pain. 2001;94:215–24.

    Article  CAS  PubMed  Google Scholar 

  100. Dworkin RH. Advances in neuropathic pain: diagnosis, mechanisms, and treatment recommendations. Arch Neurol. 2003;60:1523–34.

    Article  Google Scholar 

  101. Freynhagen R. Efficacy of pregabalin in neuropathic pain evaluated in a 12-week, randomized, double-blind, multicenter, placebo-controlled trial of flexible- and fixed-dose regimens. Pain. 2005;115:254–63.

    Article  CAS  PubMed  Google Scholar 

  102. Ross JR, Goller K, Hardy J, Riley M, Broadley K. Gabapentin is effective in the treatment of cancer-related neuropathic pain: a prospective, open-label study. J Palliat Med. 2005;8(6):1118–26.

    Article  CAS  PubMed  Google Scholar 

  103. Caraceni A, Zecca E, Bonezzi C, Arcuri E, YayaTur R, Maltoni M, Visentin M, Gorni G, Martini C, Tirelli W, Barbieri M, De Conno F. Gabapentin for neuropathic cancer pain: a randomized, controlled trial from the Gabapentin Cancer Pain Study Group. J Clin Oncol. 2004;22:2909–17.

    Article  CAS  PubMed  Google Scholar 

  104. Gilron I, Bailey JM, Tu D, Holden RR, Weaver DF, Houlden RL. Morphine, gabapentin, or their combination for neuropathic pain. N Engl J Med. 2005;352:1324–34.

    Article  CAS  PubMed  Google Scholar 

  105. Dworkin RH, O’Connor AB, Audette J, Baron R, Gourlay GK, Haanpaa ML, Kent JL, Krane EJ, Lebel A, Levy RM, Mackey SC, Mayer J, Miaskowski C, Raja SN, Rice AS, Schmader KE, Stacey B, Stanos S, Treede RD, Turk DC, Walco GA, Wells CD. Recommendations for the pharmacological management of neuropathic pain, an overview and literature update. Mayo Clin Proc. 2010;85(Suppl 3):S3–S14.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  106. Lossignol DA, Obiols-Portis M, Body J. Successful use of ketamine for intractable cancer pain. Support Care Cancer. 2005;13:188–93.

    Article  PubMed  Google Scholar 

  107. Attal N, Cruccu G, Bacon R. EFNS Guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2011;17:1113–23.

    Article  Google Scholar 

  108. Ettinger AB, Portenoy RK. The use of corticosteroids in the treatment of symptoms associated with cancer. J Pain Symptom Manage. 1994;3:99–103.

    Article  Google Scholar 

  109. Watanabe S, Bruera E. Corticosteroids as adjuvant analgesics. J Pain Symptom Manage. 1994;9:442–5.

    Article  CAS  PubMed  Google Scholar 

  110. Jacox A, Carr DB, Payne R. New clinical practice guidelines for the management of pain in patients with cancer. N Engl J Med. 1994;330:651–5.

    Article  CAS  PubMed  Google Scholar 

  111. Kerr IG, Sone M, Deangelis C, Iscoe N, MacKenzie R, Schueller T. Continuous narcotic infusion with patient-controlled analgesia for chronic cancer pain in outpatients. Ann Intern Med. 1988;108(4):554–7.

    Article  CAS  PubMed  Google Scholar 

  112. Payne R. Role of epidural and intrathecal narcotics and peptides in the management of cancer pain. Med Clin North Am. 1987;71:313–27.

    Article  CAS  PubMed  Google Scholar 

  113. Du Pen SL, Williams AR. Management of patients receiving combined epidural morphine and bupivacaine for the treatment of cancer pain. J Pain Symptom Manage. 1992;7:125–7.

    Article  CAS  PubMed  Google Scholar 

  114. Glover D, Lipton A, Keller A, et al. Intravenous pamidronate disodium treatment of bone metastases in patients with breast cancer: a dose-seeking study. Cancer. 1994;74:2949–55.

    Article  CAS  PubMed  Google Scholar 

  115. Purohit OP, Anthony C, Radstone CR, Owen J, Coleman RE. High-dose intravenous pamidronate for metastatic bone pain. Br J Cancer. 1994;70:554–8.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  116. Carlen PL, Wall PD, Nadvorna H, Steinbach T. Phantom limbs and related phenomena in recent traumatic amputations. Neurology. 1978;28:211–7.

    Article  CAS  PubMed  Google Scholar 

  117. Raj PP. Practical management of pain. Mosby Year Book: St. Louis; 1992.

    Google Scholar 

  118. Wesolowski JA, Lema MJ. Phantom limb pain. Reg Anesth. 1993;18:121–7.

    CAS  PubMed  Google Scholar 

  119. Katz J, Melzack R. Pain memories in phantom limbs: review and clinical observations. Pain. 1990;43:319–36.

    Article  CAS  PubMed  Google Scholar 

  120. Sherman RA. Stump and phantom limb pain. Neurol Clin. 1989;7:249–64.

    CAS  PubMed  Google Scholar 

  121. MacFarlane BV, Wright A, O’Callaghan J, Bensen HA. Chronic neuropathic pain and its control by drugs. Pharmacol Ther. 1997;75:1–19.

    Article  CAS  PubMed  Google Scholar 

  122. Wartan SW, Hamann W, Wedley JR, McColl I. Phantom pain and sensation among British veteran amputees. Br J Anaesth. 1997;78:652–9.

    Article  CAS  PubMed  Google Scholar 

  123. Postone N. Phantom limb pain: a review. Int J Psychiatry Med. 1987;17:57–70.

    Article  CAS  PubMed  Google Scholar 

  124. Roth YF, Sugarbaker PK. Pains and sensations after amputation: character and clinical significance. Arch Phys Med Rehabil. 1980;61:490.

    Google Scholar 

  125. Melzack R. Phantom limb pain: Implications for treatment of pathologic pain. Anesthesiology. 1971;35:409–19.

    Article  CAS  PubMed  Google Scholar 

  126. Jensen TS, Krebs B, Nielsen J, Rasmussen P. Phantom limb, phantom pain and stump pain in amputees during the first six months following amputation. Pain. 1983;17:243–56.

    Article  CAS  PubMed  Google Scholar 

  127. Nikolajsen L, Ilkjaer S, Kroner K, Christensen JH, Jensen TS. The influence of preamputation pain on postamputation stump and phantom pain. Pain. 1997;72:393–405.

    Article  CAS  PubMed  Google Scholar 

  128. Smith J, Thompson JM. Phantom limb pain and chemotherapy in pediatric amputees. Mayo Clin Proc. 1995;70:357–64.

    Article  CAS  PubMed  Google Scholar 

  129. Knox DJ, McLeod BJ, Goucke CR. Acute phantom limb pain controlled by ketamine. Anaesth Intens Care. 1995;23:620–2.

    CAS  Google Scholar 

  130. Krane EJ, Heller LB. The prevalence of phantom sensation and pain in pediatric amputees. J Pain Symptom Manage. 1995;10:21–9.

    Article  CAS  PubMed  Google Scholar 

  131. Newman P, Fawcett W. Pre-emptive analgesia. Lancet. 1993;342:562.

    Article  CAS  PubMed  Google Scholar 

  132. Katz J. Prevention of phantom pain by regional anesthesia. Lancet. 1997;349:519–20.

    Article  CAS  PubMed  Google Scholar 

  133. Katz J. Phantom limb pain. Lancet. 1997;350:1338–9.

    Article  CAS  PubMed  Google Scholar 

  134. Jahangiri M, Jayatunga AP, Bradley JWP, Dark CH. Prevention of phantom pain after major lower limb amputation by epidural infusion of diamorphine, clonidine and bupivacaine. Ann R Coll Surg Engl. 1994;76:324–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  135. Pavy TJ, Doyle DL. Prevention of phantom limb pain by infusion of local anaesthetic in the sciatic nerve. Anaesth Intens Care. 1996;24:599–600.

    CAS  Google Scholar 

  136. Malawer MM, Buch R, Khurana JS, Orth MS, Garvey T, Rice L. Postoperative infusional continuous regional analgesia. A technique for relief of postoperative pain following major extremity surgery. Clin Orthop. 1991;266:227–37.

    Google Scholar 

  137. Jaeger H, Maier C. Calcitonin in phantom limb pain: a double-blind study. Pain. 1992;48:21–7.

    Article  CAS  PubMed  Google Scholar 

  138. Nikolajsen L, Hansen CL, Nielsen J, Keller J, Arendt-Nielsen L, Jensen TS. The effect of ketamine on phantom pain: a central neuropathic disorder maintained by peripheral input. Pain. 1996;67:69–77.

    Article  CAS  PubMed  Google Scholar 

  139. McCormick Z, Chang-Chien G, Marshall B, Huang M, Harden N. Phantom limb pain: a systemic neuroanatomical-based review of pharmacologic treatment. Pain Med. 2014;15:292–305.

    Article  PubMed  Google Scholar 

  140. Varandhan KK, Lobo DN, Ljungqvist O. Enhanced recovery after surgery: the future of improving surgical care. Crit Care Clin. 2010;26(3):527–47.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Lee Ann Rhodes M.D. .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Rhodes, L.A. (2017). Pain Management for Sarcoma Patients. In: Henshaw, R. (eds) Sarcoma. Springer, Cham. https://doi.org/10.1007/978-3-319-43121-5_14

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-43121-5_14

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-43119-2

  • Online ISBN: 978-3-319-43121-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics