Esperanza Aguirre opened the Ibero American Symposium III of treatment of support and palliation in oncology.

Control the symptoms of cancer patients is essential to treat pain and other syndromes which impair the quality of life

-this meeting is intended to update the knowledge in the treatment of the cancer patient from the point of view of the treatment of the support and palliation, remarking the importance of control of symptoms, cancer patients care and sedation.

-80% of cancer patients suffer from pain resulting from the disease itself and 20% remaining sore by the effects of the treatment itself.

-half of patients with cancer pain treated analgesic inappropriate.

– according to whothe incidence of cancer in the year 2020 is estimated at 20 million people, of which around 50% will die from the disease.

Madrid, October 2009.- On 29 and 30 October is celebrated in Madrid the Ibero-American Symposium III of treatment of support and palliation in Oncology, directed by Dr. Manuel González Baron, head of the Hospital Universitario La Paz’s Oncology medical service and Director of the Chair of medical oncology and medicine palliative of the Universidad Autónoma de Madrid; and Dr. Eduardo Bruera, Director of the Department of Control symptoms and palliative care in the M.D. Anderson Cancer Center at the University of Texas, Houston.

Opened by the President of the community of Madrid, Esperanza Aguirre, brings together over 250 oncologists, paliativistas and units of oncology nurses. Among the objectives of this symposium are to update the knowledge in the treatment of the cancer patient from the point of view of the treatment of support and palliation, remarking the importance of control of symptoms, care for this type of patient and sedation. also will address innovations in recent years has been on supportpain and support treatments and controversies that have arisen in this regard, as the toxicity that produce new antineoplastic drugs and its approach.

Symptom control

For Dr. González Baron, it is essential to control symptoms in cancer patients. The symptoms are many and varied, as insomnia, the nausea, vomiting, or constipation, on occasions produces it therapeutic analgesic, such as opioids. When these symptoms are addressed properly it can significantly improve the quality of life of the patient ”.

Another key symptom is pain. About 80% of cancer patients suffering pain from the disease itself and about 20% remaining sore by the effects of the treatment itself, of which half referred pain neuropathic, produced by own chemotherapy ”, explains Dr. González Baron.

La Paz specialist qualifies that sedation is linked to the control of symptoms that not be controlled by the usual means, or even raising the dose of medication that is trying to the patient. In these cases, is required to reduce the level of consciousness. These symptoms, not already difficult to control, but refractory, are those who indician sedation ”. Among the most frequent symptoms are breathlessness, vital anguish incorrigible by other means than the sedation, anxiety and psychological distress, suffering, massive bleeding and pain. Although pain is a rarer indication to implement sedation because it can be controlled by ordinary means ”.

Inappropriate treatment

Various studies have shown that half of patients with cancer pain receive inappropriate analgesic treatment. In this sense, Dr. Eduardo Bruera, Director of the Department of Control symptoms and palliative care in the M.D. Anderson Cancer Center at the University of Texas (Houston), explains that pain and many other symptoms are not adequately evaluated and therefore often is treated with excessive or inadequate doses of analgesics. Pain in cancer patients is a multidimensional complex where participate the invasion of the tumor, but also the anxiety, depression, expectations of the patient and the family, and toxicity of drugs. An assessment of these factors is crucial to be successful in relieving pain ”.

Ultimately, it is essential to make a proper assessment of every patient’s risk factors that are contributing to the painful expression of the patient, as well as assess the own tumor.

Therefore must know the type or types of pain from the point of view pathophysiological (somatic, visceral or neuropathic), radiation, intensity (measured with an objective scale), evolution throughout the day, exacerbantes and mitigating circumstances, its interference with everyday life, associated symptomsthe psychological impact on the patient and the response to previous treatments. Only it will then be able to develop an appropriate treatment plan.

With the measures set forth by the who, which divides into three ascending steps therapeutic options are available, the pain can be controlled in a high percentage of cases. The proper handling of various drugs (NSAIDs, opiates and co-Formulants), knowledge of their side effects, loss of fear of opiates and knowledge of different syndromes associated with the cancer patient, álgicos must go hand in hand with the appropriate valuation of pain according to different scalesboth in the phase of establishment of the treatment, and follow-up of the patient. For Dr. Bruera, opioid medications are most effective. This family of drugs including morphine, hydromorphone, methadone, fentanyl, oxycodone, codeine and hydrocodone ”. They operate mainly in the brain and are drugs that in the hands of a doctor with experience they very well tolerated and relieve pain successfully the the vast majority of patients ”.