Advanced Cancer. Pain and Quality of Life (Health and Human by Edward Chow, Joav Merrick

By Edward Chow, Joav Merrick

An anticipated 166,400 new circumstances of melanoma will take place in Canada in 2008. Bone metastases regrettably stay a standard web site of recurrence, with breast and prostate melanoma sufferers representing a considerable share of this inhabitants. Metastatic bone sickness is linked to major morbidity and mortality. discomfort is skilled by means of as much as thirds of sufferers. The diagnosis for sufferers with bone metastases is extremely encouraged through tumour style, functionality prestige, and the presence of extraosseous ailment. The median survival has been considerably longer in breast melanoma sufferers with a primary relapse within the axial skeleton (24 months) as opposed to sufferers with preliminary relapse within the liver (3 months) (2). Survival after analysis of bone metastases is encouraged by means of the following improvement of extraosseous metastatic websites: 1.6 years as opposed to 2.1 years in sufferers with bone-only affliction.

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Cochrane Database Syst Rev 2002(2):002068. Section One: Pain Management In: Advanced Cancer. Pain and Quality of Life Editors: E. Chow, J. Merrick, pp. 11-17 ISBN: 978-1-61668-207-1 © 2010 Nova Science Publishers, Inc. Chapter I Psychodynamic Pain Management for Cancer Patients Frederick B. Levenson, MA, PhD, LP1, Micah D. Levenson, LMSW1, Søren Ventegodt, MD, MMedSci, EU-MSc-CAM*2,3,4,5,6 and Joav Merrick, MD, MMedSci, DMSc6,7,8,9 1 Private practice, Manhattan, New York, United States of America 2 Quality of Life Research Center, Copenhagen, Denmark 3 Research Clinic for Holistic Medicine and 4 Nordic School of Holistic Medicine, Copenhagen, Denmark 5 Scandinavian Foundation for Holistic Medicine, Sandvika, Norway and 6 Interuniversity College, Graz, Austria 7 National Institute of Child Health and Human Development 8 Office of the Medical Director, Division for Mental Retardation, Ministry of Social Affairs, Jerusalem, Israel and 9 Kentucky Children‘s Hospital, University of Kentucky, Lexington, United States The use of psychodynamic-oriented techniques has successfully been used to manage pain in 75 cancer patients by the use of psychodynamic principles.

Their resistance to a positive transference was a defense that could be resolved with reflective techniques thereby facilitating the use of these interventions. The hierarchy of degree of pain relief seemed to be 1) chemical side effects of medication being coupled with a positive suggestions of pain relief (placebo), 2) Counterfocus of irritations and pain within the soma to reduce the intensity of the actual pain site (integration of inner conflicts), 3) Directed aggressive imagery to have the patient angry at his or her pain (self-expression) and 4) Relaxation and escape imagery (letting go of tensions and negative ideas and attitudes).

Patients receiving the intervention demonstrated a significant decrease in barriers to pain control and trends toward decreased pain and symptom distress and increased functional status related to pain, pain management knowledge, and perception of control over pain. Caregivers in dyads whose home care nurse received the intervention had significant improvement in perception of control over pain. Results suggest that the ―Power Over Pain‖ intervention is effective for improving cancer pain management in the home.

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