Control of Cancer Pain with Analgesics Acting in the Central Nervous System

  • R. Wörz
Conference paper
Part of the Recent Results in Cancer Research book series (RECENTCANCER, volume 89)

Abstract

Optimal control of cancer pain requires that the problem of pain be accorded a significance of its own and that it is seen in its complexity. In the context of advanced metastatic malignancies, pain is not only a symptom but also a force with a series of pathophysiologic, psychopathologic, and social consequences (Bonica 1979). Facultatively, we find muscular tension, immobility, disturbances of respiratory and cardiovascular function, inhibition of gastrointestinal motility, disorders of sleep, depressed mood, and misanthropic behavior extending to lamentation, moaning, and crying. These effects of pain may be negatively combined with other manifestations of cancer. For example, lack of appetite due to malignancy can be intensified by pain and thus may contribute to the progress of cachexia by inadequate food intake. In therapy, besides the pathophysiology of pain, its sequelae as well as its psychodynamics and the behavior of the patient have thus also to be considered.

Keywords

Fatigue Depression Lymphoma Leukemia Morphine 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Arend J, von Arnim B, Nijssen J, Scheele J, Flohé L (1978) Tramadol und Pentazocin im klinischen Doppelblind-Crossover-Vergleich. Arzneim Forsch Drug Res 28: 199–208Google Scholar
  2. Beaver WT, Wallenstein SL, Houde RW, Rogers A (1966) A comparison of the analgesic effects of pentazocine and morphine in patients with cancer. Clin Pharmacol Ther 7: 740–751PubMedGoogle Scholar
  3. Bonica JJ (1979) Importance of the problem. In: Bonica JJ, Ventafridda V (eds) Advances in pain research and therapy, vol 2 Raven, New York, pp 1–12Google Scholar
  4. Brauchle W (1971) Erfahrungen mit einem neuen Depot-Analgetikum (Develin retard). Z Allgemeinmed 47: 1465–1467PubMedGoogle Scholar
  5. Cabanne F, Guerrin J, Wilkening M (1972) Die Behandlung von Tumorschmerzen mit Pentazocin. In: Janzen R, Keidel WD, Herz A, Steichele C (eds) Pain. Thieme, Stuttgart, pp 444–446Google Scholar
  6. Cronheim G, Thiede W (1979) Ergebnisse einer Feldstudie mit Nefopam. In: Gerbershagen HU, Cronheim G (eds) Nefopam. Ein neuartiges Analgetikum. Fischer, Stuttgart, pp 142–147Google Scholar
  7. De Thibault de Boesinghe L (1978) Double blind study of the analgesic effect of nefopam hydrochloride (Acupan) and pentazocine (Fortral) in cancer patients with pain. Curr Ther Res 24: 646–655Google Scholar
  8. Eckmann F, Kubicki SK, Mazaheri P (1975) Zur Frage einer Pentazocin-Abhängigkeit. In: Neuhaus GA, Kubicki SK (eds) Pentazocin, ein neuer Weg. Thieme, Stuttgart, pp 61–64Google Scholar
  9. Flohé L, Arend J, Cogal A, Richter W, Simon W (1978) Klinische Prüfungen der Langzeitapplikation von Tramadol. Arzneim Forsch Drug Res 28: 213–217Google Scholar
  10. Foley KM (1976) Pain syndromes in patients with cancer. In: Bonica JJ, Ventafridda V (eds) Advances in pain research and therapy, vol 2. Raven, New York, pp 59–78Google Scholar
  11. Frankendahl B, Kjellgren O (1971) Severe pain in gynecologic cancer. Cancer 27: 842–847CrossRefGoogle Scholar
  12. Frutschnigg E (1973) Schmerzbehandlung bei Karzinomen. Aerztl Praxis 25: 4429–4432Google Scholar
  13. Groh R, Schindera A, Werringloer M (1971) Klinische Erfahrungen mit dem neuen Analgetikum Tilidin-HCL. Med Klinik 66: 1241–1245Google Scholar
  14. Hoffmeister F (1968) Untersuchungen über die analgetischen, morphinantagonistischen und morphinartigen Wirkungen von Morphinantagonisten an normalen und morphinabhängigen Tieren. Pharmakopsychiatrie 1: 239–260CrossRefGoogle Scholar
  15. Houde RW (1979) Systemic analgesics and related drugs: Narcotic analgesics. In: Bonica JJ, Ventafridda V (eds) Advances in pain research and therapy, vol 2. Raven, New York, pp 263–273Google Scholar
  16. Jaffe JH, Martin WR (1980) Opoid analgesics and antagonists. In: Goodman LS, Gilman A (eds) The pharmacological basis of therapeutics. MacMillan, New York, pp 494–534Google Scholar
  17. Kleibel F (1972) Erfahrungen mit Pentazocin in der klinischen Onkologie. In: Janzen R, Keidel WD, Herz A, Steichele C (eds) Pain. Thieme, Stuttgart, pp 446–448Google Scholar
  18. Krell R, Hanke M (1979) Klinische Prüfung der analgetischen Wirksamkeit von Valoron N im Vergleich zu Valoron bei Tumorschmerzen. Krankenhausarzt 52: 760–764Google Scholar
  19. Robbie DS (1979) A trial of sublingual buprenorphine in cancer pain. Br J Clin Pharmacol 7: 3155–3175Google Scholar
  20. Schietzl M (1979) Nefopamhydrochlorid, ein neuartiges Analgetikum mit geringen Nebenwirkungen. In: Gerbershagen HU, Cronheim G (eds) Nefopam. Ein neuartiges Analgetikum. Fischer, Stuttgart, pp 129–131Google Scholar
  21. Twycross RG (1980) Overview of analgesia. In: Bonica JJ, Ventafridda V (eds) Advances in pain research and therapy, vol 2. Raven, New York, pp 617–633Google Scholar
  22. Vere DW (1978) Pharmacology of morphine drugs in terminal care. In: Vere DW (ed) Topics in therapeutics 4. Pitman, London, pp 75–83Google Scholar
  23. Zimmermann M (1979) Neurophysiologische Untersuchungen über einen spinalen Wirkungsort von Nefopam. In: Gerbershagen HU, Cronheim G (eds) Nefopam. Ein neuartiges Analgetikum. Fischer, Stuttgart New York, pp 18–26Google Scholar

Copyright information

© Springer-Verlag Berlin · Heidelberg 1984

Authors and Affiliations

  • R. Wörz
    • 1
  1. 1.Schmerz-Zentrum MainzMainzGermany

Personalised recommendations