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Pain (Professional) (cont.)

Changes to This Summary (12/30/2011)

The PDQ cancer information summaries are reviewed regularly and updated as new information becomes available. This section describes the latest changes made to this summary as of the date above.


Added text to state that the U.S. Food and Drug Administration Amendments Act of 2007 requires manufacturers to provide risk evaluation and mitigation strategies (REMS) for selected drugs to ensure that benefits outweigh risks, and that a major component of REMS requires prescribers to obtain training so that these drugs can be safely used.

Added Breivik et al. and Sun et al. as references 4 and 5, respectively.

Added financial barriers as a patient-related problem affecting pain management.

Pharmacologic Management

In Table 1, added dosing recommendations for diclofenac (oral) (Voltaren - 1% topical; Pennsaid - 1.5% topical) and for acetaminophen injection.

Added text to state that a study of 100 cancer patients treated with methadone for pain revealed a baseline electrocardiogram in 28%, with only one demonstrating a clinically significant increase in QTc at week 2 (cited Reddy et al. as reference 36).

Added text about the use of tapentadol for pain management (cited Wade et al. as reference 46 and Prommer as reference 47).

Added text to state that a 7-day buprenorphine patch is available; the maximum dose is 20 g per hour because of the potential for prolonged QTc wave interval [cited Butrans (buprenorphine) Transdermal System for transdermal administration as reference 53].

Revised text to state that transdermal buprenorphine has been used with success for the treatment of cancer-related pain in Europe, although studies in the United States are not yet published.

Added text about denosumab (cited Smith et al. as reference 258).

Radiation Therapy

This section was renamed from Antineoplastic Interventions and was extensively revised.

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