Jan Lejčko vice-president of SSLB; CLB, KARIM, Faculty Hospital Plzeň, Plzeň, Czech Republic
Tumor pain needs to be treated effectively from the beginning. Educational case study concisely demonstrates the procedure, that follows acknowledged pharmacotherapy algorithm. This algorithm is represented by a three-level analgesic scale, with analgesics chosen based on the pain intensity. The proper way is to use, at the same time, recommended "elevator principle", according to which you shouldn't unnecessarily postpone the usage of strong opioids. There is also a big problem with oncology patient's "breakthrough pain." It appears among many patients even within active oncology treatment period. Current, efficient pharmacology procedure to treat breakthrough pain is described in the casuistic. For further control over the tumor pain treatment, there is sometimes a need to use additional treatment modalities. If inconsolable pains occur during the pancreatic cancer, a neurolysis of plexus coeliacus is helpful, but this intervention should be executed shortly after diagnosis. If the pain accompanying an advanced stage of cancer is relieved, there is often a stage of life expectations re-considering, cachexia, inappetence and a loss of autarky. This pints out a need for much broader approach towards an oncology patient, than "just" suppression of somatic pain, because tumor pain has additional dimensions – mental, social and spiritual.
ROKYTA, Richard, Miloslav KRŠIAK a Jiří KOZÁK, ed. Bolest: monografie algeziologie. 2. vyd. Praha: Tigis, 2012. ISBN 978-80-8732-302-1.
HAKL, Marek. Léčba bolesti: současné přístupy k léčbě bolesti a bolestivých syndromů. 2., dopl. vyd. Praha: Mladá fronta, 2013. Aeskulap. ISBN 978-80-204-2902-5.