Breast cancer pain management - a review of current & novel therapies.
Breast cancer is one of the most prevalent cancers amongst women in the world. Unfortunately, even after adequate treatment, some patients experience severe pain either due to disease progression or due to treatment related side effects. The persistent pain causes a negative physical and psychosocial impact on patients' lives. Current rational pain management is patient-centred and requires a thorough psychological assessment. Usually adequate analgesia is achieved by adopting the WHO's three step analgesic ladder. As the disease progresses, the pain experienced by the patient also increases. This necessitates the administration of opioids and adjuvant analgesics to the breast cancer patients experiencing severe pain. However, opioid use is associated with intolerable side effects like constipation, nausea, vomiting, fear of dependence, and tolerance. Concomitant medications are required to combat these unacceptable side effects. Adjuvant analgesics need to be added to provide adequate and satisfactory analgesia. These factors worsen the psychological state of patients and deteriorate their quality of life. Hence, there is a need to develop therapeutic modalities to provide adequate analgesia with minimum side effects. This review article focuses on the current treatments available for cancer pain management, their limitations, and novel targets and non-pharmacological measures under investigation which have the potential to produce a radical change in pain management measures for the breast cancer patients.
Aanchal
A
Satija
Syed Mehmood
SM
Ahmed
Rahul
R
Gupta
Arif
A
Ahmed
Shiv Pratap Singh
SP
Rana
Suraj Pal
SP
Singh
Seema
S
Mishra
Department of Anaesthesiology, Pain & Palliative Care, Dr BRA Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India.
Sushma
S
Bhatnagar
D000700:Analgesics / Q000008:administration & dosage; D000701:Analgesics, Opioid / Q000008:administration & dosage*; D001943:Breast Neoplasms / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000473:pathology; D059408:Pain Management; D011788:Quality of Life
D000700:Analgesics; D000701:Analgesics, Opioid