Molecular Basis of Cancer Pain Management: An Updated Review

Subramaniam, Ayappa V.; Yehya, Ashwaq Hamid Salem; Oon, Chern Ein

doi:10.3390/medicina55090584

Cited by 15 publications

(8 citation statements)

References 108 publications

(246 reference statements)

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“…Furthermore, heme also regulates the metabolism of some neurosteroids and neurotransmitters (137), with a potential implication in nerve-cancer cross-talk. In addition, other than sustaining cancer, tumor innervation is also one of the main cause of chronic pain in oncologic patients, particularly those in the advanced stage of the disease (147,148). Interestingly, mutations in the heme exporter FLVCR1 have been reported in patients with peripheral sensory neuropathy (94,149,150), thus indicating an involvement of heme in pain perception.…”

Section: Heme and Tumor Microenvironmentmentioning

confidence: 99%

The Multifaceted Role of Heme in Cancer

et al. 2020

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Heme, an iron-containing porphyrin, is of vital importance for cells due to its involvement in several biological processes, including oxygen transport, energy production and drug metabolism. Besides these vital functions, heme also bears toxic properties and, therefore, the amount of heme inside the cells must be tightly regulated. Similarly, heme intake from dietary sources is strictly controlled to meet body requirements. The multifaceted nature of heme renders it a best candidate molecule exploited/controlled by tumor cells in order to modulate their energetic metabolism, to interact with the microenvironment and to sustain proliferation and survival. The present review summarizes the literature on heme and cancer, emphasizing the importance to consider heme as a prominent player in different aspects of tumor onset and progression.

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Section: Heme and Tumor Microenvironmentmentioning

confidence: 99%

The Multifaceted Role of Heme in Cancer

et al. 2020

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“…Tramadol undergoes CYP2D6 dependent O-methylation to demethyltramadol (M1). Tramadol inhibits norepinephrine reuptake and (+)-tramadol inhibits serotonin reuptake, thus, pain transmission in the spinal cord is greatly inhibited [ 11 ]. Research by Vijayan Et al.…”

Section: Discussionmentioning

confidence: 99%

Management of cancer pain with analgetic adjuvant and weak opioid in prostate cancer bone metastases: A case series

Ismy

Emril

Rizkidawati

2020

Annals of Medicine and Surgery

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Background In cancer patients, cancer pain is the most common cancer complication. About 60–90% of patients with advanced stage cancer experience various levels of pain, and about 30% of patients have been suffering from persistent severe pain. Bones are the most frequent targets of metastases in patients with cancer such as breast, prostate, lung, kidney, and thyroid. In advanced prostate cancer, bone metastasis leads to bone pain, skeletal fracture, and increased mortality. At least 75% of patients with bone metastasis experience bone pain. Case description We report three cases of cancer pain, treated with primary cancer from the prostate metastasis to the spine. All three patients had lower back pain that radiated to the left and right limbs, with mixed pain and bone pain, where early hospital admission shows the Numeric Rating Scale (NRS) pain scale 9–10. Treated with administration of adjuvant therapy (Gabapentin) and weak opioids (injections of Tramadol) as well as injections of Metylprednisolone (for 3 days), the patient's pain scale was evaluated, and the average NRS obtained on days 2–4 was 5–6. On day 5–8, treatment continued with Gabapentin and Tramadol injections, and the pain scale (NRS) decreased to 2–3. All patients on the 8-9 th day of treatment also received Biphosphonates to reduce pain, bone damage, fracture risk, and blood calcium levels. Patients can be discharged with an oral Gabapentin prescription only. Conclusion A pain scale (NRS) reduction of >50% is obtained from the initial pain scale in cancer pain patients treated using a combination of adjuvant therapy and weak opioids.

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“…Antimycotic treatment was given in clinical fungal infection, while antimycotic prophylactic therapy was given in patients with a high probability of displaying one [patients with a high grade of oral mucositis (OM), pain and dysphagia]. Table II provides the grading system for pain medications, following the World Health Organization's pain relief ladder ( 17 ).…”

Section: Methodsmentioning

confidence: 99%

“… a World Health Organization's pain relief ladder ( 17 ). NSAIDs, non-steroidal anti-inflammatory drugs.…”

Section: Figurementioning

confidence: 99%