癌症幸存者的持续性慢性疼痛:最新进展和未来方向

Sumana Choudhary, A. Saxena, Megha Bajaj, Ashima Thakur, Mayank Sonkar
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摘要

持续的慢性疼痛是癌症幸存者中最常见的残余抱怨;其病因是肿瘤的发展过程,癌症后的治疗,或任何其他并发疾病。对癌症幸存者疼痛管理的日益关注带来了巨大的挑战,因为现在超过40%的癌症幸存者的寿命超过10年。由于对乳腺癌以外的癌症幸存者持续慢性疼痛的研究有限,这一巨大的挑战仍然存在于这些癌症幸存者的疼痛管理中。癌症手术后持续疼痛的发展有无数的预测因素。更谨慎的做法是专注于慢性疼痛机制,尽管要坚持分类风险因素,并将其植入患者的治疗结果中。对于头颈癌、前列腺癌和肺癌癌症幸存者的伤害性和神经性疼痛,应采取更全面的治疗措施。在这篇文章中,我们试图回顾所有癌症幸存者治疗慢性持续性疼痛的文献,不包括乳腺癌。总之,我们想强调的是,对于癌症幸存者慢性持续性疼痛的改善或良好的结果,包括疼痛缓解技术和疼痛缓解策略,放松练习,认知行为治疗和神经康复策略在内的整体,多模式方法将被证明是巨大的帮助。疼痛管理专家和癌症幸存者之间的共同理解可以产生有益的结果。
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Persistent chronic pain in cancer survivors: An update and future directions
Persistent chronic pain is the most common residual complaint in cancer survivors; its etiology being neoplastic process, postcancer treatment, or any other concurrent disorders. Growing concern about pain management in cancer survivors throws a mammoth challenge because more than 40% of cancer survivors now live longer than 10 years. Due to limited studies on persistent chronic pain in cancer survivors other than breast cancer, this enormous challenge remains in pain management in these cancer survivors. There are innumerable predictive factors for the development of persistent pain after cancer surgeries. It would be more prudent to concentrate on chronic pain mechanisms despite holding on to categorial risk factors and implanting them into patient outcomes. An effort should be made to a more holistic management of nociceptive and neuropathic pain in cancer survivor patients of Head and Neck, Prostate, and Lung carcinoma patients. In this article, we have tried to review the literature on managing chronic persistent pain in all cancer survivors, excluding carcinoma of the breast. In conclusion, we would like to emphasize that for an improved or excellent outcome of chronic persistent pain in cancer survivors, a holistic, multimodal approach encompassing pain relief techniques and pain relief strategies, relaxation exercises, cognitive behavioral therapy, and neuro-rehabilitative strategies would prove to be of immense help. A joint understanding between the pain management expert and the cancer survivors can result in beneficial outcomes.
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