Section of Palliative Care, VA Boston Healthcare System, Harvard Medical School, Boston, MA.
Boston College William F. Connell School of Nursing and VA Boston Health Care System, Boston, MA.
Semin Radiat Oncol. 2023 Apr;33(2):93-103. doi: 10.1016/j.semradonc.2023.01.002.
Individuals with cancer experience a host of symptoms, especially when the malignancy is advanced. Pain occurs from the cancer itself or related treatments. Undertreated pain contributes to patient suffering and lack of engagement in cancer-directed therapies. Adequate pain management includes thorough assessment; treatment by radiotherapists or anesthesia pain specialists; anti-inflammatory medications, oral or intravenous opioid analgesics, and topical agents; and attention to the emotional and functional effects of pain, which may involve social workers, psychologists, speech therapists, nutritionists, physiatrists and palliative medicine providers. This review discusses typical pain syndromes arising in cancer patients undergoing radiotherapy and provides concrete recommendations for pain assessment and pharmacologic treatment.
癌症患者会出现多种症状,尤其是在恶性肿瘤晚期。疼痛可能源于癌症本身或相关治疗。疼痛未得到充分治疗会导致患者痛苦,并影响其接受癌症定向治疗。充分的疼痛管理包括全面评估;放射治疗师或麻醉疼痛专家的治疗;抗炎药物、口服或静脉用阿片类镇痛药和局部制剂;以及关注疼痛的情绪和功能影响,这可能涉及社会工作者、心理学家、言语治疗师、营养师、理疗师和姑息治疗提供者。本文讨论了正在接受放疗的癌症患者中出现的典型疼痛综合征,并为疼痛评估和药物治疗提供了具体建议。