Morphine And Metastasis
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Morphine And Metastasis
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Author : Marie-Odile Parat
language : en
Publisher: Springer Science & Business Media
Release Date : 2012-11-27
Morphine And Metastasis written by Marie-Odile Parat and has been published by Springer Science & Business Media this book supported file pdf, txt, epub, kindle and other format this book has been release on 2012-11-27 with Medical categories.
This book would combine chapters written by the most qualified authors around the world whose research encompasses the effect of morphine or other opioids on tumor growth and metastasis. This includes clinicians involved in trials determining which type of post surgical pain management can minimize the risk of recurrence or metastasis, researchers working on animal models and studying the effect of morphine on tumors, and most importantly the mechanism for this effect, and lastly cell biologists. There is currently a lot of research going on trying to reconcile the pro- and anti-cancer aspects of opioids actions.
Consequences Of Morphine Administration In Cancer Induced Bone Pain Using The Pitfalls Of Morphine Therapy To Develop Targeted Adjunct Strategies
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Author : Ashley Michele Liguori
language : en
Publisher:
Release Date : 2014
Consequences Of Morphine Administration In Cancer Induced Bone Pain Using The Pitfalls Of Morphine Therapy To Develop Targeted Adjunct Strategies written by Ashley Michele Liguori and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2014 with categories.
Many common cancers have a predisposition for bone metastasis. Tumor occupation of bone is both destructive and a source of debilitating pain in cancer patients. As a result, cancer-induced bone pain (CIBP) is the single most common form of clinical cancer pain. Opioids remain the golden standard for the management of CIBP; however,>30% of cancer patients do not experience adequate pain relief with opioids. Furthermore, clinical reports have suggested that opioids can exacerbate bone loss and increase the likelihood of skeletal-related events. To date, there is no known direct mechanism for opioid-induced bone loss (OIBL). We hypothesized that opioid off-target activation of toll-like receptor 4 (TLR4), an innate immune receptor that is expressed in bone, mediates an increase bone loss and associated CIBP. In the 66.1-BALB/cfC3H murine model of breast cancer bone metastasis, TLR4 expression is upregulated in tumor-burdened bone. Chronic morphine treatment exacerbated spontaneous and evoked pain behaviors in a manner paralleled by bone loss: we identified an increase in spontaneous fracture and osteolysis markers including serum collagen-type I (CTX) and intramedullary receptor activator of nuclear k-B ligand (RANKL). Administration of (+)naloxone, a non-opioid TLR4 antagonist, attenuated both exacerbation of CIBP and morphine-induced osteolytic changes in vivo. Morphine did not alter tumor burden in vivo or tumor cell growth in vitro. Importantly, morphine produced the in vitro differentiation and activation of osteoclasts in a dose-dependent manner that was reversible with (+)naloxone, suggesting that morphine may contribute directly to osteolytic activation. To improve opioid management of CIBP, we then posited and evaluated three novel adjunct therapeutic targets: cannabinoid receptor-2, adenosine 3 receptor and sphingosine-1-phosphate receptor 1. These pharmacological targets were identified as having a multiplicity of anti-cancer, osteoprotective and/or neuroprotective effects in addition to analgesic efficacy in chronic pain. Targets were tested in the 66.1-BALB/cfC3H model of CIBP and demonstrated to have stand-alone efficacy as antinociceptive agents. Taken together, this work provides a cautionary evaluation of opioid therapy in cancer-induced bone pain and seeks to mitigate opioid side effects through the identification of innovative adjunct therapies that can ultimately improve quality of life in patients suffering from cancer pain.
Adverse Effects Of Sustained Morphine Treatment In An Experimental Model Of Bone Cancer Pain Mechanisms That Underlie Hyperalgesia And Osteoclastogenesis
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Author : Ohannes Kevork Melemedjian
language : en
Publisher:
Release Date : 2008
Adverse Effects Of Sustained Morphine Treatment In An Experimental Model Of Bone Cancer Pain Mechanisms That Underlie Hyperalgesia And Osteoclastogenesis written by Ohannes Kevork Melemedjian and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2008 with categories.
Metastatic bone cancer is the most common cause of pain in patients with malignant tumors. Prolonged opioid treatment remains the primary method to treat pain in these patients. Sustained morphine exposure enhances both bone cancer-induced pain and bone loss in mice implanted with sarcoma cells. Sustained treatment of bone marrow cultures with morphine results in COX-2 dependent upregulation of RANKL and PGE2, and suppression of OPG. This results in increased osteoclastogenesis which was dependent on COX-2 and OPG/RANKL regulatory axis. Treatment with morphine does not induce any direct changes in osteoclasts or sarcoma cells. The in vitro data was validated in the animals where morphine induces an increase in the osteoclastogenesis and RANKL, and suppresses OPG. These data indicate that morphine enhances osteoclastogenesis by modulating the OPG/RANKL regulatory axis in osteoblasts through a COX-2 dependent mechanism. Prolonged opioid exposure induces an opioid-receptor dependent hyperalgesia in humans and in animals. Studying the direct effect of opioids on primary sensory neurons we demonstrate a modest increase in CGRP cellular content that was not opioid-receptor dependent. Although dynorphin A (2-13) and PGE2 enhanced the release of the neuropeptide, pretreatment with opioids does not influence the capsaicin or KCl evoked CGRP release. These date indicate that the neurochemical changes seen in vivo may be dependent on factors upregulated in the periphery and/or the CNS. It has been demonstrated that sensory neurons innervating the femur express markers of neuronal injury and the intramedullary region of the femur becomes devoid of nerve fibers as the tumor expands. In this study we demonstrate that the sarcoma cells generate high levels of ROS and release hydrogen peroxide into the surrounding space, which induces death and injury to both sensory neurons and glia. This death was prevented by the anti-oxidants BHA and catalase. The present study provides evidence that ROS released by cancer cells can directly lead to injury and death of sensory neurons. ROS induced injury may be one of the mechanism through which sensory neurons are injured in the murine bone cancer pain model.
Morphine And The Relief Of Cancer Pain
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Author : Robert G. Twycross
language : en
Publisher: Beaconsfield Publishers Ltd
Release Date : 1999
Morphine And The Relief Of Cancer Pain written by Robert G. Twycross and has been published by Beaconsfield Publishers Ltd this book supported file pdf, txt, epub, kindle and other format this book has been release on 1999 with Cancer categories.
For the patient - offers answers to questions frequently asked by cancer patients when advised to start morphine therapy.
A Comparison Study Of Tds Fentanyl And Tds Morphine On Late Stage Cancer Patients With Refractory Pain
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Author : GEORGIOS OIKONOMOPOULOS
language : en
Publisher:
Release Date : 2017
A Comparison Study Of Tds Fentanyl And Tds Morphine On Late Stage Cancer Patients With Refractory Pain written by GEORGIOS OIKONOMOPOULOS and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017 with categories.
Aim: Refractory cancer pain is a challenge for oncologists and pain physicians. All cancer patients with refractory pain are seen in the pain clinic and therapy is been decided in collaboration with the oncologists. TDS opioids are used but very often the patients are not comfortable. We are presenting a study where 30 patients with refractory pain who have been on TDS Fentanyl for few months with no satisfactory effect.Method: This is an open label study of 30 patients with refractory pain due to bone metastasis. On day one all patient were on TDS Fentanyl 50mcgr/h plus adjuvant analgesics. Pain scores were 7-9/10 VAS QoL scores were low (2-5/10)PF (performance status) was 3-1/5Prognosis was less than three months so the NHS could not grand these patients for a morphine pump.Patients were divided in two groups.Group one continued the pain therapy with TDS Fentanyl up to 200mcgr/h.Group two switched to TDS morphine (BUVERA) and reached 140mgr/h.We valued: 1. Pain scores, 2 nausea, 3, vomiting, 4 side effects, 5 constipation, 6 patient satisfactory and 7 QoL.Results: There was no difference in QoL and PS in the two groups.There was a small statistical difference (p=0.003) on VAS score as the Morphine group did experience less pain.There was a small statistical difference on constipation as the Morphine group experienced less. Nausea and vomiting were the same.One patient on Morphine developed acute renal failure and had to go on to dialysis for a week. She was switched back to Fentanyl TDS Conclusion: We believe that blind studies need to be done and confirm our results. In our open label study, the Morphine group did better and can be a good alternative on patients with refractory cancer pain in end stage.
Cancer Pain Management
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Author : Deborah B. McGuire
language : en
Publisher: Jones & Bartlett Learning
Release Date : 1995
Cancer Pain Management written by Deborah B. McGuire and has been published by Jones & Bartlett Learning this book supported file pdf, txt, epub, kindle and other format this book has been release on 1995 with Analgesia categories.
Cancer Pain Management, Second Edition will substantially advance pain education. The unique combination of authors -- an educator, a leading practitioner and administrator, and a research scientist -- provides comprehensive, authoritative coverage in addressing this important aspect of cancer care. The contributors, acknowledged experts in their areas, address a wide scope of issues. Educating health care providers to better assess and manage pain and improve patientsrsquo; and familiesrsquo; coping strategies are primary goals of this book. Developing research-based clinical guidelines and increasing funding for research is also covered. Ethical issues surrounding pain management and health policy implications are also explored.
Holland Frei Cancer Medicine
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Author : Robert C. Bast, Jr.
language : en
Publisher: John Wiley & Sons
Release Date : 2017-03-10
Holland Frei Cancer Medicine written by Robert C. Bast, Jr. and has been published by John Wiley & Sons this book supported file pdf, txt, epub, kindle and other format this book has been release on 2017-03-10 with Medical categories.
Holland-Frei Cancer Medicine, Ninth Edition, offers a balanced view of the most current knowledge of cancer science and clinical oncology practice. This all-new edition is the consummate reference source for medical oncologists, radiation oncologists, internists, surgical oncologists, and others who treat cancer patients. A translational perspective throughout, integrating cancer biology with cancer management providing an in depth understanding of the disease An emphasis on multidisciplinary, research-driven patient care to improve outcomes and optimal use of all appropriate therapies Cutting-edge coverage of personalized cancer care, including molecular diagnostics and therapeutics Concise, readable, clinically relevant text with algorithms, guidelines and insight into the use of both conventional and novel drugs Includes free access to the Wiley Digital Edition providing search across the book, the full reference list with web links, illustrations and photographs, and post-publication updates
Micrornas In Cancer
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Author : Cesar Lopez-Camarillo
language : en
Publisher: CRC Press
Release Date : 2013-02-22
Micrornas In Cancer written by Cesar Lopez-Camarillo and has been published by CRC Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2013-02-22 with Medical categories.
MicroRNA (miRNA) biology is a cutting-edge topic in basic as well as biomedical research. This is a specialized book focusing on the current understanding of the role of miRNAs in the development, progression, invasion, and metastasis of diverse types of cancer. It also reviews their potential for applications in cancer diagnosis, prognosis, and th
Who Guidelines For The Pharmacological And Radiotherapeutic Management Of Cancer Pain In Adults And Adolescents
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Author : World Health Organization
language : en
Publisher:
Release Date : 1981
Who Guidelines For The Pharmacological And Radiotherapeutic Management Of Cancer Pain In Adults And Adolescents written by World Health Organization and has been published by this book supported file pdf, txt, epub, kindle and other format this book has been release on 1981 with Cancer pain categories.
Endothelial Biomedicine
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Author : William C. Aird
language : en
Publisher: Cambridge University Press
Release Date : 2007-09-03
Endothelial Biomedicine written by William C. Aird and has been published by Cambridge University Press this book supported file pdf, txt, epub, kindle and other format this book has been release on 2007-09-03 with Science categories.
The endothelium, the cell layer that forms the inner lining of blood vessels, is a spatially distributed system that extends to all areas of the human body. Clinical and basic research demonstrates that the endothelium plays a crucial role in mediating homeostasis and is involved in virtually every disease, either as a primary determinant of pathophysiology or as a victim of collateral damage. The endothelium has remarkable, though largely untapped, diagnostic and therapeutic potential. This volume bridges the bench-to-bedside gap in endothelial biomedicine, advancing research and development and improving human health. The book is the first to systematically integrate knowledge about the endothelium from different organ-specific disciplines, including neurology, pulmonary, cardiology, gastroenterology, rheumatology, infectious disease, hematology-oncology, nephrology, and dermatology. It's interdisciplinary approach, which draws on expertise from such diverse fields as evolutionary biology, comparative biology, molecular and cell biology, mathematical modeling and complexity theory, translational research, and clinical medicine.