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288 Muhammad Hassan Khalil et al via space-time beamforming for early-stage breast cancer detection. IEEE Antennas and Propagation Magazine 47: 19–34 (2005). 36. Fear, E. C. Microwave Imaging of the Breast. Tech. in Cancer Research & Treatment 4 (1): 69–82 (2005). 37. Li X. & S. C. Hagness. A confocal microwave imaging algorithm for breast cancer detection. IEEE Microwave Wireless Comp. Lett. 11: 130–132 (2001). 38. Fear, E. C., J. Sill & M. A. Stuchly. Experimental Feasibility Study of Confocal Microwave Imaging for Breast Tumor Detection. IEEE Transactions on Microwave Theory and Techniques, MTT-51, March 2003, p. 887–892 (2003). 39. Doughlas, J., E.C. Fear & D. T. Westwick. Tumor Estimation in Tissue Sensing Adaption Radar (TSAR). In: Signals Canadian Conference on Electrical and Computer Engineering, p. 860–863 (2007). Computational Electrodynamics: The Finite-Difference Time- Domain Method. Artech House, Boston, MA (2000). 41. Meaney, P. M., K. D. Paulsen & T. P. Ryan. Twodimensional hybrid element image reconstruction for TM illumination. IEEE Trans. Antennas Propag. 43: 239–247 (1995). 42. Bulyshev, A. E., A. E. Souvorov, S. Y. Semenov, V. G. Posukh & Y. E. Sizov. Three-dimensional vector microwave tomography: Theory and computational experiments. Inverse Probl. 20: 1239–1259 (2004). 43. Jayanthy, M., N. Selvanathan & M. Abuon. Microwave Holographic Imaging Technique for Tumor Detection. Springer, Berlin, p. 275-277 (2000). 44. Elsdon, M., D. Smith, M. Leach & S.J. Foti. Experimental investigation of breast cancer tumor imaging using indirect microwave holography. Microwave and Optical Technology Letters 48: 480- 482 (2006). 45. Smith, D., M. Leach & A.J. Sambell. Microwave indirect Holographic Imaging using an Adaptation of Optical Techniques. IEEE Microwaves and Wireless Components Letters 13: 379-381 (2003). 46. Jacob, D., Shea, Panagiotis Kosmas, Susan C. Hagness & Barry D.Van Veen. Three-dimensional microwave imaging of realistic numerical breast phantoms via a multiple-frequency inverse scattering technique. Medical Physics 37 (8): doi. org/10.1118/1.3443569 (2010).
Proceedings of the Pakistan Academy of Sciences 49 (4): 289-294 (2012) Pakistan Academy of Sciences Copyright © Pakistan Academy of Sciences ISSN: 0377 - 2969 print / 2306 - 1448 online Review Article Pain Management in Cancer Patients: A Review Wasam Liaqat Tarar*, Sundus Sonia Butt, Fatima Amin and Mariam Zaka Butt Department of Pharmacy, Lahore College for Women University, Lahore, Pakistan Abstract: Pain management in cancer patients is a dire need which is often overlooked in the overall healthcare provided by oncologists. This review focuses on revealing the crucial trends and issues on effective pain management. The meta-analyses of previous research studies demonstrate that pain management in cancer patients is often suboptimal and there are many barriers which lead to poor pain management. According to the WHO guidelines there should be scheduled administration of drugs orally on the occurrence of pain, starting with non-opioid drugs such as acetaminophen, NSAIDs or COX-2 inhibitors following mild opioids and later strong opioids. Pain management in cancer patients is often inadequate due to the reasons as poor diagnosis of pain and reluctance of patient to take opioids or report pain. On physician’s part reasons are managing pain in cancer patients as the guidelines are available. Effective alliance with pain experts and experts on palliative care can also be helpful. There is a need for collaboration in the form of clinical teams including nurses, doctors and pharmacists rather than individual efforts to be involved in managing cancer pain. Keywords: Pain management, cancer patients, oncologists, opioids 1. INTRODUCTION A disagreeable sensory and emotional experience which is related with tissue damage either actual or potential, or expressed in terms of such damage cancer may by the tumor itself or by some medical interventions performed while diagnosing and treating the disease. Pain is divided into two sub- to the central nervous system (CNS) which results the meaning or interpretation of the pain which is (e.g., more fear may be induced by “crushing” chest pain than by the same pain intensity in any other part of human body). The experiences, behaviours The reactive component has wide variability from one individual to another [1]. 2. PREVALENCE OF CANCER PAIN Pain in cancer is widespread and its prevalence varies according to the stages of illness. Patients with early disease (48%), patients undergoing cancer treatment (59%) and 64-74% with advanced disease have cancer pain. Most of the time of cancer patients with pain is spent in the community settings until the last days of their lives. Overall, cancer pain pervasiveness in Europe is 72%. Elderly patients and those in care homes are particularly more prone to under-treatment of pain. Primary care teams along with palliative care teams are more likely to initiate and treat cancer pain, but the education of patients, caregivers and healthcare providers is of prime importance for improved patient outcomes [2, 3]. 2.1. Age and Cancer Pain Age is not found to have any correlation with the pain intensity but older patients are found to respond adversely to lower doses of drugs or potency of analgesic drugs in secondary care settings (out- ———————————————— Received, September 2012; Accepted, November 2012 *Corresponding author: Wasam Liaqat Tarar; E-mail: wasam_tarar@hotmail.com
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