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Query: UMLS:C0027627 (
metastases
)
103,950
document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)
Pain
relief from bone metastases is achieved in 80 percent of patients by local irradiation. Response to local irradiation is much faster in
metastases
from breast and lung than in prostate bone metastases. Local irradiation is also very effective in preventing pathological fractures in lytic bone lesions, and healing of the pathological fractures by new bone formation.
...
PMID:The role of radiotherapy in management of metastatic bone disease. 8 66
For the elimination of incurable
pain
in the faciocervical region caused by malignant tumours a transverse separation of the tract of the cerebral nerves V, IX, X and VII is carried out after minute stimulation at several levels under local anaesthesia. In addition, the sensitive cervical roots 1 to 3 are severed. The extent of the separation depends on the extent of the painful region and the effect of the individual separations. The method was successfully employed in 13 patients: 4 laryngeal carcinomas, 2 parotid carcinomas, 2 tongue carcinomas, 1 carcinoma of the pharynx, 1 of the maxilla, 1 of the lip, 1 of the tonsil and 1 of the Os occipitale, in most cases with submandibular
metastases
.
...
PMID:[Cervical tractotomy V, IX, X and VII and accompanying rhizotomy in incurable pain due to malignant tumors of the facial-cervical reagion]. 8 50
The short range tissue destruction of beta-emitting radioisotopes can be utilized in painful
metastatic disease
of the skeleton by employing a radionuclide that is specifically metabolized in or adjacent to these lesions. Sodium phosphate P 32 has been used for this purpose for the past 25 yr. It uptake in skeletal tumor and in osteoblastic new bone adjacent to tumor can be markedly increased by pharmacologic stimulation using androgenic steroids, or during rebound deposition after a course of parathyroid hormone. Although efficacy in terms of subjective
pain
relief is high, more objective signs of success are often lacking, and survival, while more confortable, is not prolonged. Marrow depression is the most significant side effect. A beta-emitting, bone-seeking isotope, 89Sr, may have a better therapeutic/toxic ratio, and should receive further trial. Radiation-induced necrosis has also been applied, though more hesitantly, to the proliferative, destructive, but nonmalignant synovium in rheumatoid disease. Here, a number of colloidal preparations, most commonly 198Au, have been employed. Again, relief of symptoms, particularly recurrent joint effusions, is quite high, although the basic disease process is not reversed. The major hazard here appears to be leakage of material to regional lymph nodes, resulting in irradiation of circulating lymphocytes. Although chromosomal damage can be detected when such cells are then cultured, the actual consequences of this, if any, are not presently known. Both shorter-lived (165Dy) and longer-lived (32P) larger-size colloids are being evaluated, which may prove safer in this regard than 198Au.
...
PMID:Radioisotope therapy in bone and joint disease. 9 Mar 87
Arterial embolization was performed in nine patients with
metastases
from renal carcinoma who had severe
pain
resistant to conventional therapy. Patients with
metastases
in the ilium (four), the lumbosacral spine (one), and the base of the skull (one) experienced
pain
relief lasting from one to six months. The other three patients, who had
metastases
in the proximal femur, underwent preoperative embolization to facilitate tumor curettage and internal hip fixation. No significant complications were seen with this therapeutic approach.
...
PMID:Arterial occlusion in the management of pain from metastatic renal carcinoma. 9 38
Fifteen patients with widespread painful osseous
metastases
from breast cancer unresponsive to other systemic therapy were treated with mithramycin at dose levels usually used for treating Paget's disease. Ten patients had relief of
pain
, which was marked and rapid in onset in seven. Mobility was greatly improved in four patients. Healing of bone lesions did not occur and new lesions developed while treatment was being given. Clinical response was associated with a decrease in plasma alkaline phosphatase. Toxicity was mild and consisted of nausea in most patients and a slight decrease in platelet count in one patient. Mithramycin is a useful agent for palliation of painful bone metastases and should be considered for further trials of combination chemotherapy for advanced breast cancer with bone metastases.
...
PMID:Effect of mithramycin on widespread painful bone metastases in cancer of the breast. 9 11
In a 20 year period seven cases of craniocervical chordoma were seen and treated. Since it is not possible to completely resect these lesions, the aim of treatment has been to debulk the tumor as much as feasible and employ postoperative irridation. Palliation is the most that can be hoped for, and minimal success in delaying the natural history of the tumor has been achieved. Surgery for relief of symptoms secondary to bulky recurrence is indicated for palliation, as is a repeat course of x-ray therapy. Isolated cases of long-term useful survival have followed doses in the range of 10,000 rads or more [19,20]. This therapy is usually given in smaller increments of an initial dose when there is evidence of recurrent tumor or
pain
[2]. However, whenever the dosage to the spinal cord or the base of the brain exceeds 4,000 rads, there is a concern about possible permanent radiation damage. These patients are difficult to care for late in the course of their disease when multiple cranial nerve paralysis, long tract signs, and intractable
pain
become progressively severe. Chordomas usually remain localized; however, about 10%
metastasize
distally. One case is presented of a large retropharyngeal mass with destruction of the second cervical vertebra that recurred locally in 3 months despite usual treatment; distal bony
metastases
were found 3 years after initial treatment. The histology of the lesion, its recurrence, and distal bony
metastases
were essentially indistinguishable from the other lesions that remained localized. Short periods of palliation from severe local
pain
and exquisite tenderness have been achieved by local resection of the involved bones.
...
PMID:Craniocervical chordomas. 11 69
The clinical beginning of diffuse pleural mesothelioma is a pleurisy. Initially pleura may be normal at X-ray examination, then either a pachypleuritis or a tumorous pleura appears. Thery serious since there is in the literature no cured case. The average survival time from diagnosis to death is 15 months. At terminal stage mesothelioma does not invade the other coelomic cavities. It may remain limited to the hemithorax where it has started, invading then the organs by contiguity.
Metastasis
may occur but their frequency is very variable, from 30 to 70% according the literature. On a therapeutic point of view all was tried: Surgery is rarely curative but may reduce temporarily effusion
pain
and dyspnea. Radiotherapy at high doses produces a partial effect in some series, but results are variable. Chemotherapy: adriamycin could be the most promising agent. At present time according to many authors no treatment seems to change the course of the disease.
...
PMID:[Evolutive patterns of diffuse pleural mesothelioma (author's transl)]. 11 73
The natural history, presenting signs and symptoms, and radiologic evaluation of patients with hypernephroma are reviewed. Radical nephrectomy is the treatment of choice in patients free of
metastatic disease
. Patients who have evidence of
metastatic disease
should not be subjected to nephrectomy unless hemorrhage,
pain
, or some other severe local problem warrants it. Radiotherapy and chemotherapy may be useful as adjunctive therapy in a patient with
metastatic disease
.
...
PMID:Renal cell carcinoma. 12 94
Back pain is one of the chief complaints of the elderly. It may be either a chronic deep skeletal muscular
pain
or an acute circumscribed
pain
arising from nerve-root irritation. The main causes of back pain in older people are: 1) degenerative changes (spondylosis, osteoarthritis, ankylosing hyperostosis); 2) malignancy (multiple myeloma,
metastases
from carcinoma or lymphoma); and 3) metabolic disorders (osteoporosis, osteomalacia, chondrocalcinosis, Paget's disease). Mechanisms and variations are discussed in detail.
...
PMID:Back pain: osteoarthritis. 13 24
Pain
syndromes in elderly patients are seldom psychogenic or due merely to "old age." Careful differential diagnosis is important, as judicious use of nerve blocks as adjunctive therapy often can relieve
pain
and restore activity. In the acute phase of shoulder pain, intrabursal injection of local anesthetic and steroid inhibits the inflammatory process. In the later stages, suprascapular nerve block relieves
pain
and interrupts afferent
pain
pathways. The occipital
pain
and headache of cervical arthritis also often respond to injection of 2 to 3 ml of long-acting anesthetic into the greater and lesser occipital nerves at the sites where they pierce the trapezius. Minor causalgia, shoulder-arm syndrome, or chronic traumatic edema may follow either forearm fracture or inflammation around the shoulder joint. Five stellate ganglion blocks with 1% lidocaine on alternate days, followed by 3 to 4 months of active and passive exercise, is the most effective treatment. This regimen usually produces a fully functional extremity. In degenerative disk disease, osteoarthritis, and
metastatic disease
, the cause of back pain is essentially the same--edema and inflammation of nerve roots at the intervertebral foramina. Injection of local anesthetic and steroid into the epidural space usually reduces swelling and inflammation. Patients are evaluated in 2 weeks and reblocked if improvement has plateaued.
Pain
relief most often is prompt and persists for an indefinite period.
...
PMID:Relieving pain with nerve blocks. 14 96
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