Niscola Pasquale, Tendas Andrea, Scaramucci Laura, Giovannini Marco, De Sanctis Vitaliana
Department of Hematology, S. Eugenio Hospital, Rome, Italy.
Indian J Palliat Care. 2011 Sep;17(3):175-83. doi: 10.4103/0973-1075.92333.
Patients with blood-related cancers (BRC) suffer from a substantial symptom burden, including several pain syndromes sustained by different causes and pathogenetic mechanisms. So, with regard to pain, a multifaceted clinical scenario may be observed in this setting. Indeed, pain may be correlated to disease itself, to disease-associated complications, to iatrogenic causes or may be due to unrelated clinical conditions. A close diagnostic procedure for the assessment of the underlying causes of the pain and of its pathogenetic mechanisms may direct the treatment approach which should be based on a multidisciplinary management and requires the integration of etiology-targeted interventions and painkilling drugs. The World Health Organization's three-step analgesic ladder for cancer pain relief can provide adequate pain control using oral drugs in most patients with BRC on pain, although more complex interventions may be necessary for many difficult-to-treat pain syndromes which are not infrequently encountered in this setting.
血液系统癌症（BRC）患者承受着巨大的症状负担，包括由不同原因和发病机制导致的多种疼痛综合征。因此，在这种情况下，关于疼痛可能会观察到多方面的临床情况。的确，疼痛可能与疾病本身、疾病相关并发症、医源性原因相关，或者可能是由于不相关的临床状况。用于评估疼痛潜在原因及其发病机制的严密诊断程序可以指导治疗方法，该治疗方法应基于多学科管理，并且需要整合针对病因的干预措施和止痛药物。世界卫生组织用于缓解癌症疼痛的三步镇痛阶梯疗法可以使用口服药物为大多数BRC疼痛患者提供充分的疼痛控制，尽管对于这种情况下经常遇到的许多难以治疗的疼痛综合征可能需要更复杂的干预措施。
