This review of pain management in lung cancer is based on the presentation of four cases of thoracic oncology patients with pain at various stages of their disease. The approach will be multidisciplinary, involving a thoracic oncologist, radiologist, thoracic and orthopaedic spine surgeon, radiation therapist, pain medicine specialist, and palliative care specialist. This multispecialty approach to the management of different painful presentations in thoracic oncology will demonstrate the complexity of each case and the improved patient outcomes which result from the involvement of different disciplines working in concert. In the USA, Europe and other countries, palliative care specialists often become rapidly involved in the management of these patients, coordinating social care and providing psychological support. Thoracic and orthopaedic spine subspecialists provide surgical methods to control tumour invasion, and improve quality of life and preservation of function in settings of even diffuse metastatic disease. Similarly, thoracic oncology and radiation therapists utilise both therapeutic and palliative chemotherapeutic and radiation therapy regimens to prolong and improve quality of life. The pain medicine specialist can, in addition to medication management, offer a variety of interventional approaches including unique drug delivery systems such as epidural analgesia, regional anaesthesia techniques, and intrathecal pumps, as well as neuromodulation techniques and neurolytic or neuroablative procedures. In the USA, these specialists complete an additional fellowship year in pain medicine following the completion of an anaesthesiology, physical medicine and rehabilitation, neurology or psychiatry residency. These programmes are accredited by the Accreditation Council for Graduate Medical Education, or ACGME (www.acgme.org). The availability of opioids and analgesic adjuvant medications is of great benefit in the management of cancer pain http://ow.ly/CgIF30e2UkY

中文翻译：

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胸部肿瘤学中的疼痛控制

这篇关于肺癌疼痛管理的综述基于 4 例胸部肿瘤患者在疾病的不同阶段出现疼痛的情况。该方法将是多学科的，涉及胸科肿瘤学家、放射科医师、胸外科和骨科脊柱外科医生、放射治疗师、疼痛医学专家和姑息治疗专家。这种用于管理胸部肿瘤学中不同疼痛表现的多专业方法将证明每个病例的复杂性以及由于不同学科协同工作的参与而改善的患者结果。在美国、欧洲和其他国家，姑息治疗专家经常迅速参与这些患者的管理、协调社会护理和提供心理支持。胸椎和骨科脊柱专科医生提供手术方法来控制肿瘤侵袭，并在甚至是弥漫性转移性疾病的情况下提高生活质量和功能保护。同样，胸部肿瘤学和放射治疗师利用治疗性和姑息性化疗和放射治疗方案来延长和提高生活质量。除了药物管理外，疼痛医学专家还可以提供多种介入方法，包括独特的药物输送系统，如硬膜外镇痛、区域麻醉技术和鞘内泵，以及神经调节技术和神经溶解或神经消融手术。在美国，这些专家在完成麻醉学后又完成了一年的疼痛医学研究金，物理医学和康复、神经病学或精神病学住院医师。这些课程由研究生医学教育认证委员会或 ACGME (www.acgme.org) 认证。阿片类药物和镇痛辅助药物的可用性对癌症疼痛的管理有很大好处 http://ow.ly/CgIF30e2UkY