Cancer Pain Assessment and Measurement.

OBJECTIVES: To review the incidence of cancer pain; assessment of acute, chronic, and breakthrough pain; and provide insight on assessment approaches and reliable and valid instruments for clinical and research settings. DATA SOURCES: Peer-reviewed journal articles, book chapters, Internet. CONCLUSION: Quality pain management for patients with cancer is dependent on an accurate pain assessment and ongoing reassessment, considering the whole person. Being knowledgeable about evidence-based pain assessment practices is key. IMPLICATIONS FOR NURSING PRACTICE: Concentrated efforts to address pain assessment barriers and effectively report pain assessments in diverse populations are warranted, especially in this current health care environment when pain assessment is challenging.

Breakthrough Cancer Pain: A Systematic Review of Pharmacologic Management
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BACKGROUND: Breakthrough cancer pain (BtCP), defined as a transient exacerbation of pain that occurs in conjunction with well-controlled background pain, is a common and burdensome problem in patients with cancer.
. OBJECTIVES: The aim of this systematic review is to identify evidence-based pharmacologic modalities for adequate management of BtCP. 
. METHODS: PubMed and CINAHL® databases were searched to identify literature regarding pharmacologic strategies for BtCP published from January 2006 to June 2016. These studies were then synthesized by the Oncology Nursing Society Putting Evidence Into Practice pain team. 
. FINDINGS: Forty-four studies provide evidence for the use of opioids for the management of BtCP. Transmucosal immediate-release fentanyl (TIRF) was found to have the most evidence for BtCP. Five studies and guidelines also suggest that oral opioids (not including TIRF products) be dosed proportionally to baseline opioids at 10%-20% of the 24-hour, around-the-clock dose.

Cancer-Related Pain Assessment: Monitoring the Effectiveness of Interventions.

BACKGROUND: Cancer-related pain is a major health problem because of its magnitude, the subjective nature of the pain experience, and the complexity of the disease, making it difficult to assess and control. When assessment is not performed, poor pain control can result.
. OBJECTIVES: This article provides an overview of the components of a comprehensive cancer pain assessment.
. METHODS: A review of the healthcare literature was performed.
. FINDINGS: Nurses play a key role in pain assessment by establishing patient trust and rapport, which helps to break down barriers that may stand in the way of effective pain assessment and management.

Hormone-refractory prostate cancer: a shifting paradigm in treatment.

Prostate cancer, the most common male cancer, affects one in eight American men. Risk factors for the disease include increased age, race, and family history of prostate cancer. To date, surgery, radiation, and hormonal therapy have been the mainstays of treatment. In the past, chemotherapy served only a palliative role for men with prostate cancer and failed to produce a survival advantage or any significant measurable disease response. However, for the first time, docetaxel-based regimens have demonstrated improved survival in men with hormone-refractory prostate cancer in two different, large, phase III studies. Additionally, a number of novel agents are being developed with the hope that treatment for men with hormone-refractory prostate cancer will be improved. Oncology nurses provide critical symptom management strategies as well as education to men with prostate cancer and their partners. Therefore, maintaining current state of the knowledge about best practices and treatment for prostate cancer is crucial. This, in turn, directs efforts to educate patients and family members about treatments and management of side effects.

Reactions of lithiated (E)-3-halo-1-phenylsulfonylprop-1-enes and (Z)-1-halo-3-phenylsulfonylprop-1-enes with aldehydes.

(E)-3-Chloro-1-phenylsulfonylprop-1-ene and its iodo- and bromo-analogues, (Z)-1-iodo-3-phenylsulfonylprop-1-ene and (Z)-1-bromo-3-phenylsulfonylprop-1-ene, have each been successfully converted into lithiated carbanions which react regioselectively with aromatic aldehydes to give gamma-alkylated products whose nature depends upon the halogen substituent: the chloro-sulfones yield (2Z)-1-aryl-2-chloro-4-phenylsulfonylbut-2-en-1-ols but the bromo- and iodo-derivatives behave differently, yielding (1E)-trans-4-aryl-3,4-epoxy-1-phenylsulfonylbut-1-enes. In sharp contrast, the same lithiated sulfones react with aliphatic aldehydes to give anti-configured beta-hydroxysulfones which are formed via diastereoselective alpha-alkylation reactions.