Painkillers for prostate cancer

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 a paracancer syndrome in cancer that 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

Painkillers and pain relief in oncology: rules, methods, preparations, schemes

Pain is one of the key symptoms of cancer. Its appearance indicates the presence of cancer, its progression, secondary tumor lesions. Anesthesia in oncology is the most important component of the complex treatment of a malignant tumor, which is designed not only to save the patient from suffering, but also to keep his vitality as long as possible.

Every year, up to 7 million people die from oncopathology in the world, with this pain syndrome disturbing about a third of patients in the first stages of the disease and almost everyone in advanced cases. It is extremely difficult to deal with such pain for a number of reasons, however, even those patients whose days are numbered, and the prognosis is extremely disappointing, need adequate and proper anesthesia.

Pain brings not only physical suffering, but also disrupts the psycho-emotional sphere. In Cancer patients, against the background of pain, depression develops, suicidal thoughts appear, and even attempts to die. At the present stage of development of medicine, such a phenomenon is unacceptable, because in the arsenal of oncologists there are a lot of drugs, the correct and timely administration of which in adequate doses can eliminate pain and significantly improve the quality of life, bringing it closer to that of other people.

Difficulties in pain relief in oncology are associated with a number of reasons:

• Pain is difficult to correctly assess, and some patients themselves cannot localize it or describe it correctly;
• Pain is a subjective concept, so its strength does not always correspond to what the patient describes - someone downplays it, others exaggerate it;
• Patient refusal of pain relief;
• Narcotic analgesics may not be available in sufficient quantities;
• Lack of special knowledge and a clear scheme for prescribing analgesics by oncology clinic doctors, as well as neglect of the prescribed patient regimen.

Patients with oncological processes are a special category of people, to whom the approach should be individual. It is important for a doctor to find out exactly where the pain comes from and the degree of its intensity, but due to different pain thresholds and subjective perception of negative symptoms, patients can evaluate the same pain in different ways.

According to modern data, 9 out of 10 patients can completely get rid of pain or significantly reduce it with a well-chosen analgesic regimen, but for this, the doctor must correctly determine its source and strength. In practice, things often happen differently: obviously stronger drugs are prescribed than necessary at this stage of the pathology, patients do not comply with the hourly regimen of their intake and dosage.

Causes and mechanism of pain in oncological diseases

Everyone knows that the main factor in the appearance of pain is the growing tumor itself, but there are other reasons that provoke and intensify it.Knowledge of the mechanisms of the pain syndrome is important for the doctor in the process of choosing a specific therapeutic regimen.

Pain in a cancer patient may be related to:

According to the degree of severity, weak, moderate, intense pains are distinguished, which the patient can describe as stabbing, burning, throbbing. In addition, the pain can be both intermittent and permanent. In the latter case, the risk of depressive disorders and the patient's desire to end his life is highest, while he really needs strength to fight the disease.

It is important to note that oncology pain can have different origins:

Visceral - disturbs for a long time, localized in the abdominal cavity, but at the same time the patient himself finds it difficult to say what exactly hurts (pressure in the abdomen, fullness in the back); Somatic - in the structures of the musculoskeletal system (bones, ligaments, tendons), does not have a clear localization, continuously increases and, as a rule, characterizes the progression of the disease in the form of metastasis to bone tissue and parenchymal organs; Neuropathic - associated with the action of the tumor node on nerve fibers, may occur after radiation or surgical treatment as a result of nerve damage; Psychogenic - the most "complex" pain, which is associated with emotional experiences, fears, exaggeration of the severity of the condition on the part of the patient, it is not stopped by analgesics and is usually characteristic of people prone to self-hypnosis and emotional instability. Given this versatility of the pain syndrome, it is easy to explain the lack of a universal pain reliever. When prescribing therapy, the doctor must take into account all possible pathogenetic mechanisms of the disorder, and the treatment regimen can combine not only medication support, but also the help of a psychotherapist or psychologist.

Scheme of pain therapy in oncology

To date, the most effective and appropriate is recognized as a three-stage pain treatment regimen, in which the transition to the next group of drugs is possible only if the previous one is ineffective at maximum dosages. This scheme was proposed by the World Health Organization in 1988, it is used everywhere and is equally effective in lung, stomach, breast cancer, soft tissue or bone sarcomas, and many other malignant neoplasms.

If the described sequence of pain relief is followed, the effect can be achieved in 90% of cancer patients, while mild and moderate pain disappears completely without prescribing narcotic drugs, and severe pain is eliminated with opioid narcotic drugs.

Adjuvant therapy is the use of drugs with their own beneficial properties - antidepressants (imipramine), corticosteroid hormones, anti-nausea drugs and other symptomatic drugs. They are prescribed according to indications to certain groups of patients: antidepressants and anticonvulsants for depression, neuropathic pain mechanism, and for intracranial hypertension, bone pain, compression of nerves and spinal roots by a neoplastic process - dexamethasone, prednisolone.

Glucocorticosteroids have a strong anti-inflammatory effect. In addition, they increase appetite and improve the emotional background and activity, which is extremely important for cancer patients, and can be prescribed in parallel with analgesics. The use of antidepressants, anticonvulsants, hormones allows in many cases to reduce the dose of analgesics.

When prescribing treatment, the doctor must strictly observe its basic principles:

The dosage of painkillers for oncology is selected individually based on the severity of pain, it is necessary to achieve its disappearance or an acceptable level in advanced cancer with the minimum possible amount of medication taken; The drugs are taken strictly on time, and not as the pain develops, that is, the next dose is administered before the previous one ceases to act; The dose of drugs is increased gradually, only if the maximum amount of the weaker drug is ineffective, the minimum dosage of the stronger one is prescribed; Preference should be given to dosage forms taken orally, used in the form of patches, suppositories, solutions, if ineffective, a transition to the injection route of administration of analgesics is possible. The patient is informed that the prescribed treatment should be taken by the hour and in accordance with the multiplicity and dose indicated by the oncologist. If the drug stops working, then it is first changed to an analogue from the same group, and if it is ineffective, they switch to stronger analgesics. This approach avoids an unreasonably rapid transition to strong drugs, after the start of therapy with which it will no longer be possible to return to weaker ones.

The most common mistakes that lead to the ineffectiveness of a recognized treatment regimen are considered to be an unreasonably quick transition to stronger drugs, when the possibilities of the previous group have not yet been exhausted, prescribing too high doses, which makes the likelihood of Side effects increase dramatically, while pain is not stopped, as well as non-compliance with the treatment regimen with skipping doses or increasing the intervals between doses of drugs.

I stage of analgesia

When pain occurs, non-narcotic analgesics are first prescribed - non-steroidal anti-inflammatory, antipyretic:

These drugs block the production of prostaglandins that cause pain. A feature of their action is considered to be the termination of the effect upon reaching the maximum allowable dose, they are prescribed independently for mild pain, and for moderate and severe pain syndrome - in combination with narcotic drugs. Anti-inflammatory drugs are especially effective in case of tumor metastasis to the bone tissue.

NSAIDs can be taken both in the form of tablets, powders, suspensions, and injections in the form of painkillers. The route of administration is determined by the attending physician. Considering the negative effect of NSAIDs on the mucosa of the digestive tract during enteral use, it is advisable for patients with gastritis, peptic ulcer, people over 65 years of age to use them under the cover of misoprostol or omeprazole.

The drugs described are sold in a pharmacy without a prescription, but you should not prescribe and take them on your own, without the advice of a doctor, due to possible side effects. In addition, with self-treatment, the strict analgesia regimen changes, medication can become uncontrolled, and in the future this will lead to a significant decrease in the effectiveness of therapy in general.

As monotherapy, pain treatment can be started with taking analgin, paracetamol, aspirin, piroxicam, meloxicam, etc. Combinations are possible - ibuprofen + naproxen + ketorolac or diclofenac + etodolac. Given the likely side effects, it is best to consume them after meals with milk.

Injection treatment is also possible, especially if there are contraindications to oral administration or a decrease in the effectiveness of tablets. So, analgesic injections may contain a mixture of analgin with diphenhydramine for mild pain, with insufficient effect, the antispasmodic papaverine is added, which is replaced by ketane in smokers.

The addition of analgin and diphenhydramine to ketorol can also enhance the effect. Bone pain is best eliminated by such NSAIDs as meloxicam, piroxicam, xefocam. Seduxen, tranquilizers, motilium, cerucal can be used as adjuvant treatment at the 1st stage of treatment.

II stage of treatment

When the effect of pain relief is not achieved by the maximum doses of the drugs described above, the oncologist decides to move on to the second stage of treatment. At this stage, progressive pain is stopped with weak opioid analgesics - tramadol, codeine, promedol.

Tramadol is recognized as the most popular drug because of its ease of use, because it is available in tablets, capsules, suppositories, and oral solution. It is characterized by good tolerance and relative safety even with prolonged use.

It is possible to prescribe combined drugs, which include non-narcotic painkillers (aspirin) and narcotic (codeine, oxycodone), but they have a final effective dose, upon reaching which further administration is inappropriate. Tramadol, like codeine, can be supplemented with anti-inflammatory agents (paracetamol, indomethacin).

Anesthetic for cancer in the second stage of treatment is taken every 4-6 hours, depending on the intensity of the pain syndrome and the time that the drug works in a particular patient. It is unacceptable to change the frequency of taking medications and their dosage.

Anesthetic injections in the second stage may contain tramadol and diphenhydramine (at the same time), tramadol and seduxen (in different syringes) under strict control of blood pressure.

Stage III

A strong analgesic for oncology is indicated in advanced cases of the disease (stage 4 cancer) and with the ineffectiveness of the first two steps of the analgesic regimen. The third stage includes the use of narcotic opioid drugs - morphine, fentanyl, buprenorphine, omnopon. These are centrally acting drugs that suppress the transmission of pain signals from the brain.

Narcotic analgesics have side effects, the most significant of which is addiction and a gradual weakening of the effect, requiring an increase in dose, so the need to move to the third stage is decided by a consultation of specialists. Only when it becomes known for sure that tramadol and other weaker opiates no longer work, the prescription of morphine is justified.

The preferred route of administration is by mouth, subcutaneously, into a vein, as a patch.It is highly undesirable to use them in the muscle, since in this case the patient will experience severe pain from the injection itself, and the active substance will be absorbed unevenly.

Narcotic painkillers can disrupt the functioning of the lungs, heart, and lead to hypotension, therefore, with their constant use, it is advisable to keep an antidote in the home medicine cabinet - naloxone, which, if adverse reactions develop, will quickly help the patient return to normal.

Morphine has long been one of the most prescribed drugs, the duration of the analgesic effect of which reaches 12 hours. The initial dose of 30 mg with an increase in pain and a decrease in efficiency is increased to 60, administering the drug twice a day. If the patient received pain relief injections and switches to oral treatment, then the amount of medication increases.

Buprenorphine is another narcotic analgesic that has less severe side effects than morphine. When applied under the tongue, the effect begins after a quarter of an hour and becomes maximum after 35 minutes. Buprenorphine lasts up to 8 hours, but you need to take it every 4-6 hours. When starting therapy with the drug, the oncologist will recommend bed rest for the first hour after taking a single dose of the drug. When taken in excess of the maximum daily dose of 3 mg, the effect of buprenorphine is not increased, which is always warned by the attending physician.

With constant pain of high intensity, the patient takes analgesics according to the prescribed scheme, without changing the dosage on his own and skipping the next medication. However, it happens that against the background of ongoing treatment, the pain suddenly increases, and then fast-acting drugs are indicated - fentanyl.

Fentanyl has a number of benefits:

• Speed of action;
• Strong analgesic effect;
• Increasing the dose also increases efficiency, there is no "ceiling" of action.

Fentanyl can be injected or used as part of a patch. The analgesic patch works for 3 days, when fentanyl is slowly released and enters the bloodstream. The effect of the drug begins after 12 hours, but if the patch is not enough, then additional intravenous administration is possible until the effect of the patch is achieved. The dosage of fentanyl in the patch is selected individually based on the treatment already prescribed, but older cancer patients require less than younger patients.

The use of the patch is usually indicated in the third step of the analgesic regimen, and especially in case of swallowing disorders or problems with the veins. Some patients prefer the patch as a more convenient way to take the medication. Fentanyl has side effects, including constipation, nausea, vomiting, but they are more pronounced with morphine.

In the process of dealing with pain, specialists can use a variety of ways to administer drugs, in addition to the usual intravenous and oral ones - nerve blockade with anesthetics, conduction anesthesia of the neoplasia growth zone (on the limbs, pelvic structures, spine), epidural anesthesia with the installation of a permanent catheter, injection drugs into myofascial spaces, neurosurgical operations.

Pain control at home is subject to the same requirements as in the clinic, but it is important to ensure constant monitoring of treatment and correction of doses and names of drugs. In other words, you can’t self-medicate at home, but you should strictly follow the oncologist’s prescriptions and make sure that the medicine is taken at the set time.

Folk remedies, although very popular, are still not able to stop the severe pain associated with tumors, although there are many prescriptions for acid treatment, fasting and even poisonous herbs on the Internet, which is unacceptable for cancer. It is better for patients to trust their doctor and recognize the need for drug treatment, without wasting time and resources on a knowingly ineffective fight against pain.

Author of the article: oncologist, histologist N.I. Goldenshlyuger

Strong painkillers for cancer: list, features of use

Appropriate painkillers for cancer help maintain the psycho-emotional and physiological state that can destroy the pain syndrome. After all, this disease kills millions of people every year, and most of them in the later stages of the disease begin to experience severe pain.

Strong painkillers for cancer: a list of drugs

Cancer patients in most cases suffer from pain due to the growth of cancerous tumors, less often - from antitumor treatment. Sometimes the pain syndrome has nothing to do with the disease and its treatment.

It is often quite difficult to assess the degree of pain syndrome and the question arises which painkillers for cancer can help in order to achieve a positive effect. The most effective medications proved to be the following:

• "Aspirin".
• "Sedalgin".
• "Pentalgin".
• "Diclofenac".
• "Inteban".
• "Metindol".
• "Metamizol".
• "Phenylbutazone".

In the later stages, the pain can only be relieved by more effective means. Often, only strong painkillers for cancer at the last stage can alleviate the patient's condition. Here is the most effective technique:

• "Oxycodone".
• "Tramadol".
• "Dionina".
• "Tramala".
• "Durogesica".
• MST-Continus.
• "Morphine".
• "Morphine" and its derivatives.

Features of the use of painkillers

At different stages of the pain syndrome, different groups of drugs are used. Medications can be non-narcotic and narcotic. The first group includes analgesics (some of them are available only by prescription). The second group includes opiates, which also have varying degrees of impact. However, in order for the treatment to work, painkillers for cancer must be taken according to the approved scheme:

• Non-narcotic drugs in combination with adjuvant, supportive agents.
• Weak opiates in tandem with non-narcotic and maintenance drugs.
• Strong opiates (morphine and its analogues) in combination with non-narcotic and adjuvant drugs.

The use of such a scheme contributes to the correct selection of dosages, due to which a positive effect is achieved that alleviates the suffering of the patient.

Often, painkillers for cancer are administered intravenously or intramuscularly, since with this method the effect is achieved faster than when taking tablets.

The pain that accompanies a patient with oncological pathologies is usually divided into weak, moderate and strong. Therefore, painkillers for cancer are divided into two groups: non-narcotic and narcotic drugs. Moreover, the latter can be weak and strong. Absolutely all painkillers for cancer are combined with adjuvants, which include stabilizing components that support the body of a cancer patient and can enhance the effect of basic drugs.

Non-narcotic group of painkillers

Painkillers for cancer at the initial stage relieve patients of pain without severe side effects. Non-narcotic drugs are able to suppress factors that affect the appearance of pain. However, they have the limits of anesthesia and increasing the dose will not lead to a positive result, and will also increase the impact of side effects on the body. Therefore, only a doctor can prescribe painkillers for cancer. All medicines in this group are divided into light and strong.

Light non-narcotic drugs are applicable at the initial stage of the development of the disease, when the patient does not yet have a pronounced pain syndrome. Usually, painkillers for cancer are prescribed first, which reduce the degree of pain. Recommend reception:

• "Paracetamol".
• "Aspirin".
• "Sedalgina".
• "Pentalgina".
• "Fenazone".
• "Panadola"
• Nurofen, Miga and others.

To date, painkillers for cancer have been developed that can alleviate the suffering of patients. But they can cause side effects, so you should stick to certain dosages.

Side effects

"Analgin" is prescribed in an amount of up to a thousand milligrams every three to four hours. The dosage of other analgesic drugs and "Paracetamol" can be half as low, and the interval between doses is increased to five to six hours.

Side effects from taking "Aspirin" are expressed in allergic reactions, gastrointestinal anomalies, disruption of the hemostasis system, which is responsible for the level of blood clotting.

In case of an overdose of "Paracetamol" and its analogues, toxic liver damage can be observed.

Which painkillers help with cancer: medium intensity

The doctor prescribes strong non-narcotic drugs when the patient's condition worsens and the pain becomes stronger. At this stage, the reception begins:

• "Meloxicam".
• "Tenoxicam".
• "Piroxicam".
• "Indomethacin".
• "Diclofenac".
• "Metindol".
• "Intebana".
• "Metamizol".
• "Phenylbutazone".
• "Proskine"
• "Brufena".
• "Voltarena".

These drugs are most effective in combination with analgesics, especially when the pain is caused by the spread of metastases to the bones. However, the effect of non-narcotic drugs is limited, and they are not able to relieve severe pain. Therefore, when the discomfort intensifies, stronger painkillers for cancer come into play.

Narcotic group of painkillers

Narcotic drugs are considered heavy artillery in the fight against pain.They are prescribed only as a last resort, since they not only relieve pain, but also cause irreparable harm to the patient's body at the physiological and psychological level. When prescribing narcotic drugs, it is necessary to follow a strict sequence, starting with the lightest. And when they are no longer able to help, they switch to stronger painkillers. In cancer, the use of opiates should be monitored by the attending physician, who monitors changes in the patient's condition, and, in case of intolerance or overdose, provide the necessary assistance.

Opiates are a special group of drugs that can be used in various stages of cancer. With the help of opiates, severe and moderate pain is stopped. Often, taking such drugs is prohibited at home without the supervision of a responsible health worker.

When the turn of opiates comes, treatment proceeds according to the principle: from mild to strong. The first group of narcotic drugs means the appointment:

The pharmacological form of such drugs can be tableted, encapsulated, injectable. There are drops and candles. The fastest effect is achieved through injections. The average dosage of opiates is 50 to 100 mg at intervals of 4-6 hours.

With a particularly pronounced pain syndrome, when light opiates are no longer able to cope, strong narcotic drugs come to the rescue. Common use:

• "Fentanyl"
• "Buprenorphine"
• "Prosidol"
• "Norfina"
• "Durogesica"
• MST-Continus
• "Morphine"
• "Morphine" and its derivatives.

The use of such drugs inevitably leads to dependence, and the patient has to constantly increase the dosage to maintain the effect.

All narcotic drugs are dispensed exclusively by prescription, their use is strictly controlled and accounted for. For reporting, patient representatives fill out the appropriate paperwork and provide used ampoules. To facilitate control, such drugs are issued in limited quantities, designed for a certain period of time.

If non-narcotic painkillers are prescribed for any oncological pathology, then strong narcotic drugs are used based on the type of cancer, so as not to aggravate the situation and not harm the patient.

Adjuvant agents

The group of adjuvant (auxiliary) drugs, which are of great importance in the use of painkillers, includes many medications of various directions. For complex treatment, the appointment is effective:

• corticosteroid drugs;
• antidepressants or sedatives;
• anticonvulsants;
• antihistamines;
• anti-inflammatory;
• antipyretic.

They are designed to increase the effectiveness and at the same time reduce the risk of side effects from the use of strong painkillers in oncology.

Lung cancer: how to relieve pain?

Lung cancer is one of the most common manifestations of oncology, which is often diagnosed already in the later stages, when only strong painkillers help relieve pain. Especially popular are the appointment of such means as:

Strong painkillers for lung cancer are taken under the strict supervision of a doctor.

Stomach cancer: how to alleviate suffering?

Strong painkillers for stomach cancer are also prescribed and controlled by the attending physician. Reception is often recommended:

• "Morphine".
• "Fentanyl" or "Alfantanil"
• "Oxycodone" for bone pain.
• "Methadone" for pain in nerve tissues.

Strong painkillers are selected based on the individual situation and localization of the pain syndrome.

Pain relief for breast cancer

Breast cancer has become quite widespread. Painkillers for breast cancer are also prescribed by the doctor, based on the general condition of the patient. The best effect with the least pronounced side effects was observed when taking:

It was also noted that the correct dosages of these drugs for this tumor in some women did not cause dependence and the need to increase the dose.

Basic rules for anesthesia

To achieve the maximum effect from taking painkillers, you should follow some rules:

• Pain medications for cancer should be taken on a strict schedule and dosages. This allows you to achieve maximum effect with a minimum daily amount.
• Medications should be started with mild ones and gradually moved to stronger ones.
• It is imperative to use auxiliary agents that can enhance the effect and reduce the manifestation of side effects.
• Prevention of side effects of drugs.

Anesthetic patch in oncology

Sometimes cancer patients should use fast-acting analgesics. In chronic pain syndrome, Fentanyl is the most effective. And if for some reason it is impossible for the patient to get an injection, then a patch with this medicine comes to the rescue.

Anesthetic components are released from the patch for three days. The greatest efficiency is achieved 12 hours after application. The dosage of the drug is calculated individually, and age is an important factor.

Anesthetic patch helps in cases where the patient is difficult to swallow or eat due to damage to the veins. For some patients, this type of anesthesia is simply convenient.

Malignant neoplasms and metastases cause irreversible changes and degradation of healthy tissues. In this case, the nerve endings are damaged and inflammatory processes occur, which are accompanied by severe pain. In order to somehow help the patient maintain his psychological and physical condition, anesthetics are prescribed during treatment. What painkillers can be used for cancer, the doctor determines individually depending on the stage of the disease and susceptibility to active substances.