Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0027651 (tumor)
 685,946 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The prevalence and nature of pain in the population of children and young adults with malignancy treated by the Pediatric Branch of the National Cancer Institute were assessed over a 6 month period. One hundred and thirty-nine patients were evaluated during 161 in-patient days and 195 out-patient clinic visits. Approximately 50% of the patients assessed in the hospital and 25% of the patients assessed in the out-patient clinic were found to be experiencing some degree of pain at the time of assessment. Therapy-related pain predominated in both in-patients and out-patients; only one-third of the pain experienced by in-patients and less than 20% of the pain experienced by out-patients was due to tumor. Tumor pain was due primarily to bony invasion. In order to control pain in those individuals experiencing pain, narcotic analgesics were being used by one-half of the in-patients and one-third of the out-patients. Overall pain control was good, with the medium visual analogue scale score being 26 mm on a 0-100 mm scale. During the study period 7 patients were identified to have chronic pain for greater than 1 year following eradication of all known tumor from the site of pain. One was receiving massive doses of narcotics (120 mg/day of methadone) apparently out of proportion to his underlying pain.
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PMID:The prevalence of pain in a pediatric and young adult cancer population. 358 2

Palliative medicine has as its goal improving the quality of life of patients with incurable diseases and their family members. According to the WHO, alleviating pain and other physical symptoms, as well as addressing psycho-social and spiritual problems have the highest priority. The role of medicine and the physician is inseparably linked to psycho-social and nursing resources in a multi-disciplinary team. Advanced stages of cancer are particularly characterized by symptoms which can cause lasting impairment of normal life. In addition to pain, patients suffer from other, often extremely distressing physical symptoms such as constipation, nausea and vomiting, gastrointestinal obstruction and difficulty in breathing. The first priority is to determine the causes of the individual symptoms, since therapeutic decisions are based on the specific pathophysiological mechanisms. Effective symptom management presupposes exact knowledge of the pharmacokinetics. The often difficult decision between causal and symptomatic therapy options must - whenever possible - be made together with the patient and frequently in interdisciplinary medical consultation. Tumor pain therapy follows the guidelines of the World Health Organization. Crucial are long-term therapy and dose titration of the analgesics, stepped progression between the groups of medication, and specific therapy approaches for neuropathic pain components. The significance of constipation with its variety of possible complications is often underestimated in the context of the tumor patient. Effective prophylaxis and cause-based therapy do improve the nutritional care and can help to prevent the transition to an ileus. New findings concerning the role of neurotransmitters in triggering nausea and vomiting have opened up specific methods of attack. Dyspnoea therapy places high demands on the medical team, since nursing measures must effectively supplement the more limited medical possibilities.
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PMID:[Symptom control in palliative medicine]. 1181 Mar 72

Combretastatin A-4 phosphate (CA4P) is a novel antitumor vascular targeting agent, the first agent of this class of compounds to enter the clinic. We performed a Phase I trial to determine the maximum-tolerated dose, safety, and pharmacokinetic profile of CA4P on a single-dose i.v. schedule. We also obtained preliminary data on its effect on tumor blood flow using dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) techniques and cell adhesion molecules at the higher-dose levels. Twenty-five assessable patients with advanced cancer received a total of 107 cycles over the following dose escalation schema: 18, 36, 60, 90 mg/m(2) as a 10-min infusion and 60 mg/m(2) as a 60-min infusion at 3-week intervals. There was no significant myelotoxicity, stomatitis, or alopecia. Tumor pain was a unique side effect, which occurred in 10% of cycles, and there were four episodes of dose-limiting toxicity at dosages > or =60 mg/m(2), including two episodes of acute coronary syndrome. Pharmacokinetics revealed rapid dephosphorylation of the parent compound (CA4P) to combretastatin A4 (CA4), with a short plasma half-life (approximately 30 min). A significant (P < 0.03) decline in gradient peak tumor blood flow by DCE-MRI in six of seven patients treated at 60 mg/m(2) was observed. A patient with anaplastic thyroid cancer had a complete response and is alive 30 months after treatment. The toxicity profile is consistent with a drug that is "vascularly active" and devoid of traditional "cytotoxic" side effects. Dosages < or =60 mg/m(2) as a 10-min infusion define the upper boundary of the maximum-tolerated dose.
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PMID:A phase I pharmacokinetic and translational study of the novel vascular targeting agent combretastatin a-4 phosphate on a single-dose intravenous schedule in patients with advanced cancer. 1206 83

Tumor pain occurs in 70-80% of all cancer patients who have reached an advanced tumor stage. In the case of failure or poor response to chemotherapy and in cases of recurrence following radiotherapy, tumors will often become enlarged with infiltration of organs, nerve roots or bone which causes severe pain to the patient. Interventional radiological minimally invasive local tumor therapy is often the last resort for tumor patients suffering from severe pain. Interventional radiologists have several options to treat tumor pain but firstly the cause of the pain must be identified. This article presents a classification of patients suffering from tumor pain which can help therapists to decide on the correct form of treatment. Treatment options are discussed using typical case histories and it is shown that patients suffering from severe tumor pain must be treated sequentially, which means that treatment is carried out in multiple steps and each cycle of therapy has to be adapted to the stage of the disease. Local pain treatment is fundamentally based on individual case decisions which should be discussed within an interdisciplinary tumor board and the panel should arrive at a consensus decision. In addition, the radiologist performing the procedure should have many years of experience in interventional oncological radiology. By fulfilling these conditions the interventional radiologist can help the patient in a variety of ways because the available treatment options are effective and do not result in much distress for the patient.
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PMID:[Interventional radiological treatment of tumor pain]. 2606 55