Tramadol for prostate cancer

Prostate cancer pain. Question from Valentine.

Content:

My father-in-law was diagnosed with stage 4 Prostate cancer. in June 2013, her PSA was over 100, she had a bilateral orchidectomy and was treated with Bicalutamide 50 mg, Painkillers Tramadol. At the beginning of September 2014, the doctor changed the dosage of Bicalutamide to 150 mg, after some time the pain intensified and the left leg swelled from the bottom to the knee joint. What can be done and how to relieve the pain?

Prostate cancer is a fairly well treatable tumor, even at stage 4 (tumor growth into adjacent organs, regional lymph nodes and / or distant metastases). The treatment in this case is non-surgical, since it is impossible to radically remove the tumor, hormone therapy plus chemotherapy and radiation treatment is usually used.

Hormonal treatment of stage 4 prostate cancer

In the case of your relative, a bilateral orchidectomy (removal of both testicles) was performed - an analogue of chemical castration, which reduces testosterone production to almost nothing. Testosterone and its toxic metabolites (dihydrotestosterone) stimulate the division of prostate cells, increasing the tumor and metastases, provoking the formation of new ones. 90% of testosterone is produced in the testicles, the remaining 10 - in the adrenal glands.

Surgical castration is a fairly simple operation that reduces testosterone in the blood in 3-12 hours, associated with complications of anesthesia, bleeding and infection (quite rare).

Surgical castration is often combined with medication to completely suppress the synthesis of testosterone in the adrenal glands; for this, antiandrogens are used - the non-steroidal drug Bicalutimide, which blocks androgen receptors in organs and tissues.

The drug is quite well tolerated, can cause typical antiandrogenic effects: decreased libido and potency, hair loss, allergies, gynecomastia, hot flashes, osteoporosis, anemia, muscle loss, obesity and edema, fatigue and depression, diarrhea and nausea, problems with liver, increased blood sugar levels, nonspecific pain. The dosage of 150 mg is the usual for locally advanced non-metastatic prostate cancer.

Tramadol is a non-narcotic opioid analgesic that is not addictive, but has the side effects of opioids: intestinal atony, dizziness, dry mouth, palpitations, collapse and drop in blood pressure.

Symptoms during treatment

The fact that the pain intensified is usually a symptom of tumor progression, new metastatic screenings, but here you need the advice of an oncologist. A new symptom - swelling of the left leg from below to the knee - is not characteristic of either tramadol or bicalutimide. This is most likely venous thrombosis, which is characteristic of all oncological processes (thrombosis as a paracancer syndrome in cancer) and a decrease in testosterone levels. It is necessary to consult an oncologist, ultrasound with dopplerometry of the veins of the lower extremities, a blood coagulogram. All these drugs are narcotic and prescribed by a doctor!

A good effective analgesic drug flupirtine (Katadolon) of a non-narcotic series, which is taken 1-2 capsules up to three to four times a day, no longer than 2 weeks.

Five-year survival rate for stage 4 prostate cancer - from 50-60% in the absence of distant metastases to 30% if they are present, a total of 6-7 years.

General information

Tramadol (tablets, injections) prescribed for oncology is recommended if the pain syndrome is assessed as moderate and severe in intensity. The drug can be used not only in case of pain associated with malignant processes, but also with pain of a different etiology. Often, the remedy is prescribed to people who are worried about the pain syndrome against the background of an injury or surgery. If a medical manipulation or diagnosis is expected, which brings a strong discomfort to the patient, the drug can be used as a means to relieve sensations during the process.

The doctor who prescribes this remedy will tell you about how often to give Tramadol injections in oncology, how many tablets to take per day and at what time. The dosage is always selected strictly individually. It is necessary to consider what the pains are, how strong they are.

About dosage

When prescribing "Tramadol" for oncology, the doctor takes into account the age group and the characteristics of the patient's health. If a person is older than 14 years of age, the pain syndrome is assessed as moderate, 1 ml of the drug is administered in one procedure, which corresponds to 50 mg of the hydrochloride of the active substance. If after half an hour or an hour the pain does not subside, the reception is repeated.

If the pain is severe, you can use the medication with four-hour intervals between doses. A single dosage reaches 0.5 g. If this dosage option is chosen, it is necessary to control the patient's condition, preferably with the help of modern equipment.

Action features

Widely used in therapeutic practice for oncology and metastases, "Tramadol" is prescribed to alleviate the pain caused by the pathological process. Tests have shown that the analgesic effect is observed within 4-8 hours. In general, it is recommended to use no more than 0.4 g of the drug per day, but a malignant neoplasm and surgery on the patient allow an increase in doses at the discretion of the doctor.

If it is necessary to achieve a pronounced analgesic effect in the case when the patient's age is older than one year old, but less than 14 years old, a single dosage is selected based on the patient's weight. It is recommended to take 1-2 mg of the substance for each kilogram. It is desirable to use the agent in the form for injective administration. To dilute the contents, purified water prepared for injections is used.

Application rules

Produced in ampoules "Tramadol" in oncology is prescribed to relieve pain caused by the malignant process and the selected treatment methods. In order for the drug to show the desired effect, it must be administered correctly. If the medicine is injected into a vein, slow administration is required. It is allowed to inject an analgesic into muscle tissue and subcutaneously.

It is possible to prescribe "Tramadol" if the patient has kidney or liver failure. This condition requires a specialized dosage. The approach is similar in the case of old age. If the pain is severe, "Tramadol" is used once a day or less. In chronic pain syndrome, the intervals between doses should be made as long as possible, since the duration of the half-life of the drug increases, there is a risk of a cumulative effect.

If the patient is older than 75 years of age, even with normal functioning of the liver and kidneys, it is necessary to prescribe "Tramadol" with the longest possible intervals between doses.

Does it help or not?

There are practically no reviews from patients about the use of Tramadol in oncology and metastases. As a rule, with such a diagnosis, the remedy is prescribed at the fourth stage, when the patient's condition is already quite bad. You can meet the responses of people who cared for such patients. Many recognize that "Tramadol" at first has a strong, pronounced effect, but its duration is rather short, so you have to use the remedy often. Doctors note that in the case of a severe oncological process, "Tramadol" must be used in such dosages and with such frequency that it alleviates pain - that is, choose individually, controlling the patient's condition.

As can be seen from the reviews, injections of "Tramadol" in oncology can improve the quality of life of the patient, make the last stage of an incurable disease less painful. When the medication stops showing the desired result, it is combined with other painkillers. "Tramadol" is considered the penultimate method of pain relief in cancer patients. Only "Promedol" has an even stronger effect, which is prescribed if "Tramadol" ceases to act, the pain becomes too intense.

Unwanted consequences

As can be concluded from the reviews, with oncology "Tramadol" (tablets, injections) can cause unwanted side reactions from the patient's body. Many note that the head hurts and is spinning, the stool is disturbed and nauseous. Sometimes patients vomit. There is a possibility of itchy lesions on the skin, asthenia and dyspepsia. Some have symptoms of psychostimulation, excessive activity of sweat glands, diarrhea. There may be a feeling of dry mucous membranes of the mouth.

In 5% of patients, pressure decreases, weight decreases, tachycardia develops. Approximately the same frequency of cases of paresthesia, tremor, abdominal pain, visual impairment. There is a risk of hallucinations and decreased diuresis. The likelihood of any side effect becomes higher if Tramadol is used for a long time, at a high dosage. At high doses, there is a possibility of getting used to the remedy.

Safety First

If Tramadol has caused adverse reactions in oncology that are not described in the instructions for use accompanying the drug, you should consult your doctor. This probably indicates a poor tolerance of the agent by the body. The doctor will select an analogue or advise you to completely abandon the drug.

It is forbidden to use "Tramadol" if the patient uses MAOIs, and also within a couple of weeks after stopping the course of such treatment. The drug is prohibited for pregnant and lactating women. In the case of lactation, an exception is possible if the patient's vital signs require it. The medicine is not used for children under one year of age.

As can be seen from the reviews, in oncology, Tramadol is prescribed to relieve pain, while the therapeutic program is associated with the risk of developing a hypersensitivity reaction. Such manifestations are a categorical contraindication to continuing treatment. Also limitations are conditions in which the activity of the central nervous system, the respiratory center is depressed. This is possible with alcohol poisoning, excessive use of sleeping pills, psychotropic, narcotic analgesic medicinal composition.

Security considerations

According to the reviews, in oncology, "Tramadol" is sometimes necessary to prescribe to persons who have liver or kidney failure, as well as to people who have had a head injury, patients with epilepsy. Sometimes it becomes necessary to prescribe an analgesic to people who have increased intracranial pressure, as well as people who are inherently dependent on opioid formulations. All these cases require the use of an anesthetic strictly under the supervision of a doctor, carefully and with regular checks on the body's performance.

Extremely carefully, only if it is possible to constantly monitor the patient's condition, "Tramadol" is prescribed against the background of anesthetics, psychotropic and sleeping pills. Combined use with narcotic painkillers should be avoided, since such a practice is associated with an increased risk of unpredictable mutual influence of drugs.

About combinations and risks

As can be seen from the reviews, in oncology, Tramadol is sometimes prescribed to people who need drugs containing carbamazepine. With such complex treatment, the effectiveness of the painkiller may decrease.

Alcoholic beverages should be avoided while using the analgesic.

When using an anesthetic, you should refrain from driving machines, units, devices that require an increased reaction rate and special attention. Work under such conditions should be avoided.

Isn't that too much?

According to reviews, in oncology, "Tramadol" is used to relieve pain of medium and high strength, and it is recommended to choose the frequency of use individually, taking into account the characteristics of the case. For this reason, there is a risk of drug overdose. Such a condition can be suspected by the patient's convulsions and depression of the respiratory center.

In order to provide first aid to the patient, it is necessary to ensure ventilation of the pulmonary system. Urgent hospitalization in the intensive care unit was recommended with connection to specialized equipment and the appointment of funds for the relief of symptoms inherent in a particular case. Blood dialysis does not give the desired result. With convulsions, you can assign "Diazepam". The use of "Naloxone" is practically ineffective, as it does not allow to stop the symptoms of the toxic effects of the drug, in addition, it increases the risk of convulsions.

Mutual influence

If the patient is shown drugs that depress the central nervous system, the combination of these drugs with "Tramadol" can cause mutual activation of the central effects. The same process is observed when drinking alcohol. The likelihood of inhibition of the respiratory function of the body increases. It is known that in rare cases, patients who used neuroleptics against the background of anesthesia with Tramadol developed epileptic seizures. Under the influence of carbamazepine, the period of effectiveness of the analgesic in question is reduced, its analgesic effect is weakened.

Combining with MAOIs is accompanied by an increased risk of developing CNS conditions that threaten the life of the patient. Possible inhibition of respiratory activity and impaired blood flow.

All variants of the combined influence of drugs on each other can develop with prolonged use, and in the case of a short-term, single dose.

Usage: reasonable and in moderation

In medicine, there are many cases of dependence on opioid medications. Among other drugs that can provoke addiction, Tramadol poses a certain danger. Although it is usually prescribed for cancer patients, and people who have used the analgesic for a long period admit that there is no dependence, the unjustified use of the drug turns it into a drug. This applies to non-medical uses.

The abuse of "Tramadol" is accompanied by a violation of behavioral reactions and the formation of mental abnormalities. Officially, this medication does not belong to the list of narcotic drugs, but is classified as a potent drug formulation. Excessive use is classified in the legal sciences as substance abuse.

Curious to know

Earlier, "Tramadol" belonged to the class of narcotic painkillers.The revision of affiliation was made on the basis of numerous scientific papers that showed that among opiate addicts, people with Tramadol addiction are very rare. In addition, tolerance to the active compound of the drug is formed only with a low degree of probability.

Currently, Tramadol is one of the fairly affordable drugs. In pharmacies, the medication is dispensed strictly with a prescription from the attending physician

List of painkillers for prostate cancer

Taking painkillers for prostate cancer is necessary and justified, starting from the 3rd stage of the disease. Increased pain indicates the progression of the pathology and the release of new metastatic screenings outside the prostate region. Almost all drugs are regulated drugs (drugs).

Oncology of the 4th degree is more often indicated by a new symptom - swelling of the left leg from the heel to the knee. It is mistakenly taken as a side effect from taking Tramadol, Bicalutamide. But oncologists more often refute this, pointing to a possible venous thrombosis as a result of paracancer syndrome in cancer, which accompanies all oncological processes with a parallel decrease in testosterone levels.

Preparations for pain relief:

• At the 1st stage: NSAIDs (Ketoprofen, Aspirin, Indomethacin, Ibuprofen, Diclofenac). In the future, they are prescribed together with strong analgesics.
• At the 2nd stage: NSAIDs do not help, opioids of various forms of release are prescribed (Tramadol, Tramal). If they are intolerant, they are replaced with Prosidol, Buprenorphine.
• At the 3rd stage: Buprenorphine, Morphine can anesthetize prostate cancer.
• At the 4th stage, very strong drugs are used: Diphereline, Casodex, Nobedolak, Zometa.

With concomitant internal pathologies (gastrointestinal ulcer, constipation, intestinal atony, etc.), transdermal patches with Fendivia, Dolorphine, Fentandol, Lunaldin are prescribed. It is important to understand that we are not talking about a cure for cancer, the progression of the disease is almost inevitable if the disease is not detected at an early stage of development and the tumor focus has not been successfully removed.

As a rule, a strong pain syndrome characterizes the 4th stage of cancer with damage to the pelvic bones and the formation of foci of metastases in them. Any painkillers are prescribed by an oncologist due to the development of a scheme and the issuance of strict medications