Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two open-label, multicenter studies were conducted to evaluate the efficacy and safety of a long-acting depot formulation of leuprolide acetate (22.5 mg) administered intramuscularly every 12 weeks to patients with stage D2 prostate cancer. Clinical evaluations were performed every 12 weeks, and serum testosterone levels were monitored biweekly or weekly for 24 weeks. Onset of castrate levels (< or = 50 ng/dL) of testosterone was achieved within 30 days of the initial depot injection in 87 (95%) of the 92 assessable patients enrolled in the two studies. Mean testosterone levels remained well within the castrate range throughout each dosing interval. Two patients experienced a transient escape (testosterone levels > 50 ng/dL on two consecutive determinations). Delay of an injection of up to 2 weeks did not have an effect on testosterone suppression: in 16 patients in whom the depot injection was delayed by 3 to 14 days, testosterone values remained within the castrate range. A favorable objective tumor response (no progression) to treatment occurred in 85% of the patients. Prostate-specific antigen and prostatic acid phosphatase decreased by 50% or more in 96% and 84% of patients, respectively, with elevated pretreatment values and at least one treatment value. Assessment of local disease status and overall performance status showed improvement or stability in most patients. The most common adverse events were hot flashes (59%), pain (27%), and testicular atrophy (21%). The 22.5-mg depot formulation of leuprolide, which acts in a manner similar to the monthly 7.5-mg depot formulation, was shown to be effective and safe in treating patients with advanced prostate cancer.
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PMID:Leuprolide acetate 22.5 mg 12-week depot formulation in the treatment of patients with advanced prostate cancer. 887 93

Palliation is the principal aim of treatment for patients with advanced prostate cancer. In a strict sense, "palliation" means reduction of existing symptoms, but in clinical practice a further goal is to prolong the symptom-free interval in asymptomatic patients and to prevent distressing problems, such as pain and fatigue, with the overall aim of improving quality of life. In patients with advanced prostate cancer, quality of life parameters represent an important endpoint in clinical routine and in clinical trials. Evaluation of quality of life issues also provides independent prognostic information. A feasible approach for regular quality of life assessment is the use of a questionnaire developed for cancer patients together with psychometrically tested disease-specific and treatment-specific modules designed to evaluate the various factors, such as micturition, sexuality, vitality, and intestinal problems for localized prostate cancer, and bone pain, micturition, sexuality, hot flashes, gynecomastia, and gastrointestinal problems for metastatic prostate cancer.
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PMID:Quality of life in advanced prostate cancer. 899 83

The results of hormonal examinations, measurements of dimensions of the uterus and leiomyomas, body weight, and also frequency of incurred climacteric signs in patients treated with Decapeptyl Depot 3.75 mg for three months are reported. Subjects consisted of 12 women, among whom nine were treated for leiomyomas and four for endometriosis (one patient also had leiomyomas). Based on examinations carried out, the biggest decrease of the uterus and leiomyomas was 13-17% observed just after two doses of analog, though after the end of treatment the dimensions of the uterus slowly increased. Therefore, 2-month therapy could be used successfully as preparation for further conservative surgical treatment. Significant increase of body weight in treated patients was not observed. In women with endometriosis pain symptoms in the hypogastric area and dyspareunia regressed during treatment and at the end were not observed. The disadvantages of therapy with Decapeptyl Depot 3.75 was the rapid occurrence of symptoms--climacteric signs, especially hot flashes--which were badly tolerated by patients. All these symptoms almost totally regressed one month after ending therapy.
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PMID:GnRH analogs in treating uterine leiomyomata and endometriosis. 900 82

Menopause is an expected event in a woman's life. Treatment for breast cancer can impact the onset of menopause and precipitate symptoms such as hot flashes. Yet this sequelae of events is not well measured, defined or assimilated into quality of life assessments for cancer survivors. Though not life threatening, hot flashes can greatly impact a woman's quality of life or functional ability. It is important for health care professionals to more fully understand the nature of the experience of hot flashes so as not to underestimate their disruptive potential. As part of a larger clinical trial to look at the effectiveness of vitamin E for hot flashes, breast cancer survivors kept a log of both the frequency and intensity of their hot flashes. These women then wrote descriptions to define the severity of those hot flashes. The purpose of this paper is to provide insight into the experience of hot flashes in breast cancer survivors and to describe the severity of hot flashes with narratives given by the women experiencing them.
J Pain Symptom Manage 1998 Nov
PMID:Definitions of hot flashes in breast cancer survivors. 984 28

Little is known about the long-term effects of adjuvant therapy on quality of life, sexual functioning and symptoms in breast cancer survivors. Between January 1996 and June 1997, we surveyed 1098 women who had been diagnosed with early stage breast cancer between 1 and 5 years earlier. The breast cancer survivors were recruited in two large metropolitan centers in the USA. They completed a survey battery that contained standardized measures of health-related quality of life (HRQL), depression, body image, sexual functioning, and symptoms. A total of 1096 had usable responses for these analyses. In this sample, n = 356 had received tamoxifen (TAM) alone, n = 180 received chemotherapy (CHEM) alone, n = 395 received CHEM + TAM, and n = 265 received no adjuvant therapy (NO RX). There were significant differences in the mean age of each group, with the TAM group being the oldest (mean 62.6 years) and the CHEM group being the youngest (mean 46.8 years). Both age and time since diagnosis were controlled for in all statistical analyses. We found no significant differences in global quality of life among the four treatment groups. For the MOS-SF-36, there were no significant differences on the subscale scores except for the physical functioning subscale (p = 0.0002); the NO RX group had the highest functioning. There were no significant differences in depression scores among the four treatment groups. The MOS-SF-36 physical functioning composite score differed by treatment group (p = 0.012); the NO RX group had a physical functioning composite score that was at the mean for a normal healthy population of women, while those in the adjuvant treatment groups scored slightly lower. The mental health composite score was not significantly different among the four treatment groups and approximated scores from the normal population of healthy women. There were no differences in body image scores among the four treatment groups; however, sexual functioning scores did differ (p = 0.0078) with patients receiving chemotherapy (either alone or with tamoxifen) experiencing more problems. Hot flashes, night sweats, and vaginal discharge differed by treatment (p = 0.0001); all symptoms were reported more often in breast cancer survivors on tamoxifen. Vaginal dryness and pain with intercourse also differed significantly by adjuvant treatment, occurring more often in survivors treated with chemotherapy. Overall, breast cancer survivors function at a high level, similar to healthy women without cancer. However, compared to survivors with no adjuvant therapy, those who received chemotherapy have significantly more sexual problems, and those treated with tamoxifen experience more vasomotor symptoms.
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PMID:Impact of different adjuvant therapy strategies on quality of life in breast cancer survivors. 992 75

This review compares the tolerability profiles of the three currently available nonsteroidal antiandrogens, flutamide, bicalutamide and nilutamide. Pharmacological effects associated with blockade of the androgen receptor are frequent with all three drugs. Gynecomastia and breast pain are seen more frequently during antiandrogen monotherapy than during combination with medical or surgical castration or castration alone, and the reverse is true for hot flashes, which are a side effect of castration. Gastrointestinal symptoms are also common to all three drugs, but diarrhea occurs more frequently in flutamide studies than in bicalutamide or nilutamide studies. Hepatotoxicity has been seen with all three antiandrogens, but acute, reversible hepatitis and fatal fulminant hepatitis have also been reported with both nilutamide and flutamide. All three drugs have been associated with asymptomatic elevations in aminotransferases and may reduce hemoglobin levels. Adverse events that have been reported with nilutamide include interstitial pneumonitis, delayed adaptation to darkness after exposure to bright light and alcohol intolerance. To date, bicalutamide appears to have some advantage over flutamide and nilutamide in terms of tolerability.
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PMID:Tolerability of Nonsteroidal Antiandrogens in the Treatment of Advanced Prostate Cancer. 1038 26

Hot flashes are among the most commonly reported symptoms among women who have completed treatment for breast cancer. Relatively little is known, however, about hot flashes among women while they are undergoing breast cancer treatment. The present study investigated the prevalence and severity of hot flashes of women during chemotherapy and radiotherapy for breast cancer. We also sought to identify the medical, demographic, and treatment correlates of hot flashes during treatment and to document the impact of hot flashes on quality of life. Seventy postmenopausal women with breast cancer completed a self-report questionnaire packet during chemotherapy and radiotherapy. Forty percent (n = 28) reported hot flashes during the week prior to assessment. Of the 28 women endorsing hot flashes, 25% (n = 7) rated them as severe, 39% (n = 11) rated them as moderate, and 36% (n = 10) rated them as mild. Women with hot flashes were significantly (p < 0.05) younger and reported significantly (p < 0.001) more fatigue, poorer sleep quality, and poorer physical health compared to women without hot flashes. Multivariate analyses revealed that, even after controlling for relevant medical, demographic, and treatment variables, the prevalence of hot flashes significantly (p < 0.05) predicted poorer sleep quality, more fatigue, and worse physical health. The results indicate that hot flashes are experienced by a sizable percentage of postmenopausal breast cancer patients as they undergo treatment. Hot flashes during cancer treatment appear to have a negative impact upon patient quality of life that may be due, in part, to fatigue and interference with sleep. Future research should seek to evaluate interventions to relieve hot flashes during breast cancer treatment as a means of improving patient quality of life.
J Pain Symptom Manage 2000 Jun
PMID:Impact of hot flashes on quality of life among postmenopausal women being treated for breast cancer. 1090 24

To assess the psychometric properties of the Hot Flash Related Daily Interference Scale (HFRDIS), a sample of breast cancer survivors and an age-matched comparison group completed a questionnaire packet and 2-day prospective hot flash diary at an initial time point and again 6 months later. There were 71 breast cancer survivors and 63 comparators at Time 1, and 54 survivors and 46 comparators at Time 2. The HFRDIS was internally consistent, with alphas of 0.96 at times 1 and 2. Validity was supported through 1) correlations with other hot flash variables, 2) correlations with measures of affect and mood, 3) significant differences between women with hot flashes and those without, and 4) demonstrated sensitivity to change over time. The HFRDIS is a psychometrically sound measure for assessing the impact of hot flashes on daily activities and overall quality of life in clinical practice or research protocols.
J Pain Symptom Manage 2001 Dec
PMID:The Hot Flash Related Daily Interference Scale: a tool for assessing the impact of hot flashes on quality of life following breast cancer. 1173 60

Abrupt onset of hot flashes poses a significant problem for women treated with chemotherapy for breast cancer. Alternatives to hormone replacement, such as the use of the selective serotonin re-uptake inhibitor (SSRI) paroxetine hydrochloride, are being explored as therapies for hot flashes in this patient population. The present study investigated the efficacy of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer. This study included 13 patients who were seen in the Psychosocial Clinic at Moffitt Cancer Center. They were referred by their medical oncologist after reporting complaints of significant difficulty with hot flashes. Baseline questionnaires were completed and a structured diagnostic interview for clinical depression was conducted, all of which were repeated 5 weeks after the paroxetine 20 mg daily was started. Significant improvements were seen in the ratings of hot flash severity (P = 0.002). In addition, significant improvements were observed in general, emotional, and mental fatigue. Rates of clinically significant depressive symptomatology also decreased and sleep quality improved significantly as well. Finally, the incidence of clinical depression improved from 39% at baseline to 8% after treatment. These preliminary data suggest that the antidepressant paroxetine can be helpful in the treatment of hot flashes and associated fatigue, sleep disturbance, and depression in women with breast cancer treated with chemotherapy. Further controlled studies are needed to more fully evaluate the efficacy of the SSRIs for hot flashes in women with breast cancer.
J Pain Symptom Manage 2002 Apr
PMID:A pilot trial of paroxetine for the treatment of hot flashes and associated symptoms in women with breast cancer. 1199 3

Choosing a contraceptive method for a woman with endometriosis is an uncommon problem because endometriosis is relatively rare and because an estimated 30-50% of women with endometriosis are infertile. Uterine or internal endometriosis or adenomyosis is characterized by a congestive and pseudoinflammatory uterus slightly increased in volume. It must be distinguished from pelvic or external or peritoneo-ovarian endometriosis. Pelvic implants may involve destruction of the ovaries by cysts or their imprisonment in adhesions. They may cause stenosis in the proximal portion of the tubes or entrap them in adhesions. 4 stages of endometriosis have been distinguished according to the significance of the lesions and a scoring system. Stage 4 patients with scores over 70 or with a score over 50 for adhesions have been unable to conceive despite treatment. No contraception is necessary in these cases. The choice of a contraceptive for other patients is conditioned by the features of endometriosis. Endometriosis refers to the abnormal localization of a normal endometrium. The implants are sensitive to estrogen. Each implant behaves like a miniature uterus; the mucus proliferates and bleeds if estrogen secretions are present, or atrophies if not. Endometriosis may be completely asymptomatic, or cause sterility, or be accompanied by pain and metrorrhagia. Several earlier treatments of endometriosis have been abandoned because of side effects. The current treatment of choice is an LHRH analog administered by parenteral injections every 4 weeks to bring about a state of pseudomenopause. The treatment produces a rapid desensitization of the pituitary LHRH receptors and a diminution of gonadotrophins, estrogens, and progesterone. The secondary effects are those of hypoestrogenism: hot flashes, vaginal dryness, and increased bone loss after 6 months of treatment. It is also an expensive medication. Contraception is provided by the treatment itself for the first 6 months. Subsequently, a hydroxyprogesterone derivative such as cyproterone acetate can be used, as can a norpregnane derivative or a combined oral contraceptive with predominant progestin action. Monophasic pills containing norethisterone are also acceptable. In case of metabolic problems, a pill containing gestodene may be used. A vaginal contraceptive should be used in cases of adenomyosis.
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PMID:[Contraception and endometriosis]. 1228 94


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