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Any drug has side effects, should be chosen “lesser evil.”

About 80% of advanced cancer accompanied by severe pain, severe pain will lead to speed up the heart rate, blood pressure, elevated blood glucose, the body decreased immunity and a series of side-effects, so that the patient’s body faster collapse, experts recommend patients do not Blind refusal to take analgesics such as morphine.

Advanced cancer, most patients will be faced with a full range of pain. When doctors usually advise them to take morphine-like potent analgesics. But the question is, will gradually take morphine addiction, which many patients have a resistance, many people would rather put up with the pain of torture do not want to do nothing as “drug addicts.” The Guangzhou University of Traditional Chinese Medicine First Affiliated Hospital of Professor Ma Wuhua think: after all, Aimo on the human body than the destruction of morphine generated by the more serious side effects, he suggested that patients should be “lesser evil” Do not blindly refuse to take morphine. This is because only the most hard to solve the problem of cancer pain, sleep in order to protect and improve appetite and prevent depression and anxiety in patients with mood, which is to improve the quality of life in patients with the late great significance.

80 advanced cancer patients with severe pain

The major hospitals in oncology, patients often can hear the groans of pain, but the reporter has learned that although the suffering of the difficult, but not all patients are willing to take analgesics such as morphine. Lung cancer nearly in the late Zhang is one of the “die-hard elements.”During the hospitalization, he often pain in the evening, a doctor, asking him to oral morphine, and he had argued with the doctor on duty, said doctors should not “harm”, he will eat addictive drug.

“A lot of morphine for patients with advanced cancer have resistance.” MA Wu Hua, on the one hand, taking morphine can be hard to solve the patient’s symptoms and avoid pain brought about by a series of side-effects, conducive to the treatment of disease, but on the other hand , It would be very addictive morphine, but that was after the long-term thing, step back, even become addicted, should be “lesser evil.”

Severe pain brought about by a series of side-effects

According to the MA Wu Hua, about 80% of advanced cancer patients have severe pain, it is estimated that at least a day of the world’s 1,500 million people suffering from cancer pain and torment. At this stage, patients in a mental and physical anguish, a considerable number of patients died of cancer is not direct, but died of severe pain. As the sharp pain will lead to speed up the heart rate, blood pressure, elevated blood glucose, the body decreased immunity and a series of side-effects, so that the patient’s body more quickly collapse.

MA Wu Hua pointed out that the pain is often full, and the common parts of a chest pain in the back, neck, abdomen, pelvis, chest and bones and so on. In addition, the tumor itself can produce some hormone-like chemicals, necrotic tissue decomposition, and other objects can be further intensified in all parts of the pain.As a result, at a later stage, patients often find it difficult to accurately depict the nature or location of the pain. Pain is also often have a strong sense of abnormal autonomic, mental and physical strength so that patients have decreased. MA Wu said that China, in all cases of intractable pain, there are “→ pain, insomnia fatigue → → → insomnia pain” of such a vicious cycle and lead to patients with anxiety and depression. There are statistics that chronic pain in patients with depression in the incidence of 30% to 60%.

Morphine will help improve the quality of life

For cancer patients, the use of morphine is not just to solve the “pain” but also can help patients to improve sleep and improve appetite and reduce anxiety and depression, and enhance the body’s resistance to improve the quality of life of patients and at the same time and then Assisted in the relevant active treatment can help patients with long-term survival. “Like high blood pressure, diabetes, like the need for a lifetime of drug control, there are side effects, but with a serious illness, the side effects against the relatively much smaller.” MA Wu Hua said.

The treatment of cancer pain

Internationally popular “three-step program”

According to the MA Wu Hua, the treatment of cancer pain, recognized internationally popular “three-step program” —

The first step: for mild and moderate degrees of pain around. Preferred non-opioid drugs, mainly non-steroidal anti-inflammatory drugs such as aspirin, acetaminophen, ibuprofen, diclofenac sodium, etc. mainly.

The second step: the main medium for local pain, often persistent pain, the patient’s sleep has been disturbed, the appetite has decreased. Such pain in patients with weak to be effective application of opioids, but the medication should be taken in principle, the principle of progressive, that is to give non-steroidal anti-inflammatory drugs at the same time, support given to analgesic drugs, such as tramadol or weak effect of opiates Such as cocaine, and so on. At night can be nerve to take antipsychotic and hypnotic, and so on.

Third step: for moderate and severe pain should be used to morphine represented by the strong painkillers. Such effective pain relief drug. However, consideration should be given to age, gender, body, the type of cancer and severe pain and the extent and many other factors. Individual differences in a large amount of drugs is usually recommended by the beginning of low-dose, according to the clinical experience to be appropriate doses.

Of course, in addition to morphine, there are many effective means of pain can be resolved, such as radiation therapy, nerve damage treatment of peripheral nerve damage and block, damaged spinal nerve block, epidural nerve damage-resistance Lag, the celiac plexus block ethanol, and so on.

“WHO” six principles of treatment of cancer pain

Experts pointed out that should the use of analgesic pain medication to improve the quality of life of patients, which, the World Health Organization has also given the 6 specific treatment principles:

(1) Individual: analgesic dose should vary from person to person.

(2) the best oral drug delivery: I do not need medication to help other people, more convenient. Regularly oral morphine has become the treatment of chronic cancer pain, the main means.

(3) active treatment of insomnia: The pain frequently during the night increased in patients with sleep disturbance. This situation can lead to failure in the body. Application of the night a larger dose of morphine, and time may be extended pain in patients with sleep.

(4) side effects of treatment in a timely manner: strong opioids common side effects such as constipation, nausea and vomiting, should be given antiemetic gentle cathartic.

(5) examine the effect of: patient pain medication, no matter what kind of analgesic drugs, need to carefully observe in order to obtain the best effect and minimal side effects.

(6) grasp the nature of cancer pain: As the saying goes “right”, the treatment of cancer pain is no exception.

In addition, the WHO also recommended morphine as a potent drug for the treatment of cancer pain, morphine and pointed out that in most of the world’s countries and regions can be found, and cheap; In addition, the medical profession on morphine pharmacokinetics and adverse reactions And so on have been fully aware that in the event of a poisoning antidote naloxone can be used.In addition, morphine and time to play a role equal to the half-life, can increase the dose and route of administration flexibility, the analgesic effect for a long time and fewer complications.