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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An adenocarcinoma of the second portion of the duodenum in a 26-year-old male is presented. The patient was suffering from pain in the epigastrium. Immunofluorescent studies revealed that it consisted almost exclusively of cells with a distincly positive somatostatin-like immunoreactivity. Ultrastructurally, the cytoplasm of the tumor cells had numerous large round granules (about 400 micrometers) with variable electron density. Most of these cells closely resembled the D cells normally seen in the duodenum and the islets of the pancreas, although a few argyrophil cells could be demonstrated by light microscopy. Radioimmunoassay of extracts of the tumor revealed a large amount of somatostatin (2260 pg/mg); substance P and VIP were detected also. Somatostatinoma has been known to occur in the pancreas, but this seems to be the first somatostatinoma found in the intestine.
Cancer 1979 Dec
PMID:Somatostatinoma of the duodenum. 50 96

Self-assessments of 34 spouses of patients who had died from cancer at St Christopher's Hospice were compared with self-assessments of a matched group of spouses of patients who had died in other hospitals in the vicinity. The spouses of St Christopher's patients differed significantly from the comparison group in spending more time at the hospital, talking to more members of staff, other patients and visitors, reporting less anxiety and psychosomatic accompaniments of anxiety before (but not after) the patient's death and being less worried about pain, others hurting or harming the patient or about revealing their own fears to the patient. The institutional ideals of the Hospice were characterized as: 'The hospital is like a family', 'Nothing is too much trouble' and 'Don't worry'.
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PMID:Terminal care: evaluation of in-patient service at St Christopher's Hospice. Part II. Self assessments of effects of the service on surviving spouses. 51 28

Pain due to bone metastasis in hormonodependent cancer (of the breast or the prostates more particularly) can be relieved by surgery directed at the endocrinic system. The most efficient techniques are hypophysectomies and hypophysiolysis (or neuroadenolysis). The intrasellar injection of alcohol through the transnasal-transsphenoidal route is a fairly simple procedure which can be carried out on such fragile patients without too much risk. The authors here report the first results obtained with this procedure in 12 pateints. Full sedation of pain is achieved in 30 to 40 p. cent of the cases. The duration of analgesia varies and pain frequently returns. One of the advantages of this procedure lies in the fact that such an injection may be repeated if necessary. The intrasellar injection of alcohol is but one of the many techniques available to practitioners working in the field of intractable pain.
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PMID:[Pain due to bone metastasis in hormonodependent cancer. Treatment by intrasellar injection of alcohol (author's transl)]. 52 38

The pains that may accompany cancer of the lung vary from relatively benign to very severe. Careful clinical observation will establish that the pains occur in distinct syndromes (patterns). Six syndromes have been identified and described. When a syndrome has been established it tends to persist, although a second syndrome may be added. Recognition of the syndromes helps the clinician to make a prognosis and to plan for management of the pain.
Pain 1979 Dec
PMID:The nature of pain that may accompany cancer of the lung. 53 Jul 43

This paper provides an overview of the current status of the management of cancer pain. The concept of "total care" of the patient with cancer incorporates an effort to eradicate or suppress the underlying malignancy, but when this is no longer feasible emphasis is shifted to symptom control to maximize the quality of remaining life. Even though the malignancy cannot be eradicated, an important first step in pain control is the diagnostic identification of the source of pain because it is preferable to treat the pain specifically rather than symptomatically. Alleviation of the patient's "total agony" requires treatment of the emotional as well as the physical component of pain. In addition, successful management is facilitated by attention to the social needs of both patient and family. Pharmacological therapy is the keystone of pain management; this includes the use of psychotropic agents and narcotic analgesics given orally on a regular schedule to prevent pain, rather than treating the pain after it has appeared. The hospice approach embodies the principles of pharmacological therapy and social, spiritual, and emotional support for the patient and family. These noninvasive methods have been shown to be effective in an increasing proportion of patients with advanced cancer, resulting in a decline in the need for neurosurgical intervention. However, in some patients conservative management fails and neurosurgical intervention should be considered. For those who are candidates for neurosurgical intervention, a wide variety of procedures is available. The selection of specific procedures depends on the source and severity of the pain and on the life expectancy and general condition of the patient.
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PMID:Management of cancer pain: an overview. 53 57

Fifty one patients with terminal cancer suffering severe pains reluctant to other treatment have received morphine by mouth, in a regular regimen. The doses range between 5 and 50 mg every 4 hours. 60% of our patients have their pain alleviated without any side effect impeding the treatment.
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PMID:[Treatment of chronic pain in advanced malignant disease by oral morphine (author's transl)]. 53 69

This paper is based on 21 patients with metastases of the choroid from extraocular tumors, observed over a period of 25 years (1952--1977) at Erlangen University Eye Clinic. Approximately 70% of these relatively rare metastases of the choroid are caused by cancer of the breast. Ophthalmoscopically, they are usually localized to the left of the posterior pole and are yellowish. In about 20% of the cases both eyes are affected. Since breast cancer is the most frequent cause of the primary tumor, women in the 40 to 60 age group are the most common sufferers. On the other hand, it is worth mentioning that in 2 cases the metastases were the first signs of any type of malignancy. Typical is the relatively flat, shell-like growth. In cytological specimens the portion of the retina covering the tumor normally shows no evidence of cystic degenerative change, in contrast to malignant melanoma. In view of the short average life expectancy of about 9 months, therapy should consist in preserving the eye and thus some degree of vision. Radiotherapy, chemotherapy or cytostatic therapy whould be tried. Enucleation is only indicated where there is severe pain, secondary glaucoma, amaurosis or if it is impossible to differentiate from a malignant melanoma.
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PMID:[Tumor metastases of the choroid: clinical picture and histology (author's transl)]. 54 92

Among 276 married patients with cancer under the age of 65 who died in two South London boroughs during the period 1967 to 1971, 41 were still under active treatment at the time of death. I studied the remaining 85 per cent who experienced some form of terminal care, and in particular compared reports by the surviving spouses of 65 patients whose care was home-centred and 100 hospital-centred patients.Although home-centred care was most often chosen for patients who were said to have had little severe pain before the period of terminal care, during that period there was a sharp increase in reports of pain, much of it severe and unrelieved. Hospital-centred patients were said to have had much less pain and more confusion during the final phase of care and were more likely to have been confined to bed than those at home. The amount of anxiety reported by the patient's spouse was not markedly different under the two patterns of care, nor did the pattern of care influence subsequent adjustment to bereavement.Qualitative differences between the two groups are considered and it is concluded that although home-centred care can be successful it is often associated with unnecessary suffering. Implications for the home care of the terminally ill are discussed.
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PMID:Home or hospital? Terminal care as seen by surviving spouses. 55 66

Alcohol celiac plexus nerve blocks were done in 100 patients, of whome 97 had intractable abdominal pain from cancer. In most cases, an initial diagnositc block with bupivacaine was followed by the therapeutic block performed by injecting 50 ml of 50 percent ethyl alcohol. Good to excellent pain relief occurred in 94 percent of patients. Fourteen blocks were repeated for recurrent pain. Life duration ranged from 2 days to 14 months after the block. Complications and side effects were infrequently seen but did include a 10 percent incidence of postural hypotension and 1 case of partial leg paralysis. This block is remarkably safe as well as effective and should be employed more frequently.
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PMID:Abdominal pain and alcohol celiac plexus nerve block. 55 95

In exploring new modalities to control or ameliorate unbearable intractable pain associated with invasive cancer, the authors studied the effectiveness and safety of a new method involving the destruction of the pituitary by injection of absolute alcohol into the gland. Of a series of 24 patients undergoing pituitary adenolysis for control of cancer pain, 13 patients experienced complete and lasting relief and 10 showed significant improvement. The authors hope that the encouraging results obtained in this preliminary study will stimulate other investigators also to employ the transnasal, transphenoidal approach to alcohol-induced hypophysectomy for the control of intractable pain due to advanced cancer.
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PMID:Alcohol-induced adenolysis of the pituitary gland: a new approach to control of intractable cancer pain. 55 44


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