A report on Cancer pain

Chemotherapy drugs
Cross-section of the spinal cord showing the dorsal column and the anterolateral spinothalamic tracts
Cross section of the spinal cord showing the subarachnoid cavity, dura mater and spinal nerve roots including the dorsal root ganglion

Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response.

- Cancer pain
Chemotherapy drugs

11 related topics with Alpha

Overall
Chemical structure of morphine, the prototypical opioid.

Opioid

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Opioids are substances that act on opioid receptors to produce morphine-like effects.

Opioids are substances that act on opioid receptors to produce morphine-like effects.

Chemical structure of morphine, the prototypical opioid.
US. Top line represents the number of benzodiazepine deaths that also involved opioids. Bottom line represents benzodiazepine deaths that did not involve opioids.
Locants of the morphine molecule
INTA: selective agonist of KOR-DOR and KOR-MOR heteromers. Does not recruit β-arrestin II. Antinociceptive devoid of aversion, tolerance, and dependence in mice.
A sample of raw opium
US yearly deaths from all opioid drugs. Included in this number are opioid analgesics, along with heroin and illicit .<ref name=NIDA-deaths/>
US yearly deaths involving other, predominately Fentanyl.<ref name=NIDA-deaths/>
US yearly deaths involving prescription opioids. is a category dominated by illegally acquired fentanyl, and has been excluded.<ref name=NIDA-deaths>Overdose Death Rates. By National Institute on Drug Abuse (NIDA).</ref>
US yearly overdose deaths involving heroin.<ref name=NIDA-deaths/>

In many cases opioids are a successful long-term care strategy for those with chronic cancer pain.

An illustration of wrist pain

Pain

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Distressing feeling often caused by intense or damaging stimuli.

Distressing feeling often caused by intense or damaging stimuli.

An illustration of wrist pain
Portrait of René Descartes by Jan Baptist Weenix, 1647-1649
Regions of the cerebral cortex associated with pain.
Mechanism of nociceptive pain.

Pain is usually transitory, lasting only until the noxious stimulus is removed or the underlying damage or pathology has healed, but some painful conditions, such as rheumatoid arthritis, peripheral neuropathy, cancer and idiopathic pain, may persist for years.

Active and inactive μ-opioid receptors

Pain management

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Aspect of medicine and health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging.

Aspect of medicine and health care involving relief of pain in various dimensions, from acute and simple to chronic and challenging.

Active and inactive μ-opioid receptors
Young children can indicate their level of pain by pointing to the appropriate face on a children's pain scale

It was first described for use in cancer pain.

Chronic pain

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Classified as pain that lasts longer than three to six months.

Classified as pain that lasts longer than three to six months.

There is limited evidence that cancer pain or chronic pain from tissue damage as a result of a conditions (e.g. rheumatoid arthritis) is best treated with opioids.

Opium poppies such as this one provide ingredients for the class of analgesics called opiates

Analgesic

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Analgesic, pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain .

Analgesic, pain reliever, or painkiller, is any member of the group of drugs used to achieve relief from pain .

Opium poppies such as this one provide ingredients for the class of analgesics called opiates
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In combination with opioid pain medication, paracetamol is now used for more severe pain such as cancer pain and after surgery.

The recreational drug lean can be created with codeine syrup (pictured).

Codeine

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Opiate and prodrug of morphine used to treat pain, coughing, and diarrhea.

Opiate and prodrug of morphine used to treat pain, coughing, and diarrhea.

The recreational drug lean can be created with codeine syrup (pictured).

Weak evidence indicates that it is useful in cancer pain, but it may have increased adverse effects, especially constipation, compared to other opioids.

Fentanyl

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Powerful opioid used as a pain medication and, together with other medications, for anesthesia.

Powerful opioid used as a pain medication and, together with other medications, for anesthesia.

A fentanyl nasal spray with a strength of 100 μg per use
A fentanyl transdermal patch with a release rate of 12 micrograms per hour, on a person's arm
US yearly overdose deaths, and some of the drugs involved. Among the more than 70,200 deaths estimated in 2017, the sharpest increase occurred among deaths related to fentanyl and fentanyl analogs (other ) with over 28,400 overdose deaths.
US yearly deaths involving other, predominantly fentanyl.
A package of 30 tablets, 600 mcg of fentanyl, each
Fentanyl powder (23% fentanyl) seized by a sheriff

It is also used in the management of chronic pain including cancer pain.

Important pathways of paracetamol metabolism.

Paracetamol

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Medication used to treat fever and mild to moderate pain.

Medication used to treat fever and mild to moderate pain.

Important pathways of paracetamol metabolism.
Classical methods for the production of paracetamol.
Paracetamol crystals (crystallized from an aqueous solution) under a microscope.
Julius Axelrod (pictured) and Bernard Brodie demonstrated that acetanilide and phenacetin are both metabolized to paracetamol, which is a better-tolerated analgesic.

The evidence in its favor for the use in low back pain, cancer pain, and neuropathic pain is insufficient.

7 places that forensic scientists look to find drugs in the body.

Route of administration

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Way by which a drug, fluid, poison, or other substance is taken into the body.

Way by which a drug, fluid, poison, or other substance is taken into the body.

7 places that forensic scientists look to find drugs in the body.
Oral administration of a liquid.
A medical professional injects medication into a gastric tube.
Administering medication rectally
Needle insertion angles for 4 types of parenteral administration of medication: intramuscular, subcutaneous, intravenous, and intradermal injection.
A transdermal patch which delivers medication is applied to the skin. The patch is labelled with the time and date of administration as well as the administrator's initials.
A medical professional applies nose drops.
Intraocular administration
A dummy wears a nebulizer mask, used to administer inhaled medications.
A peripheral IV placed on the hand.
A medical professional performs an intradermal (ID) injection.
Involved subjects' positions.

Intracerebroventricular (into the cerebral ventricles) administration into the ventricular system of the brain. One use is as a last line of opioid treatment for terminal cancer patients with intractable cancer pain.

Endoscopic image of an esophageal adenocarcinoma

Esophageal cancer

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Cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.

Cancer arising from the esophagus—the food pipe that runs between the throat and the stomach.

Endoscopic image of an esophageal adenocarcinoma
Esophageal cancer (lower part) as a result of Barrettʼs esophagus
Esophageal cancer as shown by a filling defect during an upper GI series
Esophageal stent for esophageal cancer
Esophageal stent for esophageal cancer
Before and after a total esophagectomy
Typical scar lines after the two main methods of surgery
Death from esophageal cancer per million persons in 2012
Endoscopic image of Barrett esophagus – a frequent precursor of esophageal adenocarcinoma
Endoscopy and radial endoscopic ultrasound images of a submucosal tumor in the central portion of the esophagus
Contrast CT scan showing an esophageal tumor (axial view)
Contrast CT scan showing an esophageal tumor (coronal view)
Esophageal cancer
Micrograph showing histopathological appearance of an esophageal adenocarcinoma (dark blue – upper-left of image) and normal squamous epithelium (upper-right of image) at H&E staining
T1, T2, and T3 stages of esophageal cancer
Stage T4 esophageal cancer
Esophageal cancer with spread to lymph nodes
Internal radiotherapy for esophageal cancer
Self-expandable metallic stents are sometimes used for palliative care

Pain behind the breastbone or in the region around the stomach often feels like heartburn.