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Use of nonsteroidal anti-inflammatory drugs in cancer
1St Christopher's Hospice, London, UK.
Abstract:
Nonsteroidal anti-inflammatory drugs (NSAIDs) are widely used in cancer, yet they are also responsible for many, often serious, adverse effects. This review examines the various mechanisms through which NSAIDs work. It looks at the experience built up in using NSAIDs in cancer pain in general, but then particularly examines whether the evidence available supports the claim often made that these drugs have a specific role in relief of pain from bony metastases. Criteria for choosing one NSAID over another, including adverse effect profiles, efficacy and tolerability, are considered, as are methods for improving the safe use of these drugs.
Insights
Nonsteroidal anti-inflammatory drugs (NSAIDs) effectively manage cancer pain, particularly bone metastasis pain. However, their serious adverse effects necessitate careful selection and safe usage strategies.
Area of Science:
- Oncology
- Pharmacology
- Pain Management
Background:
- Nonsteroidal anti-inflammatory drugs (NSAIDs) are frequently utilized in cancer care.
- Despite their benefits, NSAIDs are associated with numerous, potentially severe, adverse effects.
- Understanding NSAID mechanisms is crucial for optimizing their use in cancer patients.
Purpose of the Study:
- To review the mechanisms of action for NSAIDs.
- To evaluate the efficacy of NSAIDs in managing general cancer pain.
- To specifically assess the evidence supporting NSAIDs for pain relief in bony metastases.
Main Methods:
- Literature review of NSAID mechanisms.
- Analysis of clinical experience with NSAIDs in cancer pain.
- Examination of evidence for NSAID use in bony metastases pain.
- Evaluation of criteria for NSAID selection (efficacy, tolerability, adverse effects).
Main Results:
- NSAIDs exhibit diverse mechanisms relevant to cancer pain.
- Evidence supports NSAID use for general cancer pain.
- Specific evidence for NSAID efficacy in bony metastases pain requires further investigation.
- Adverse effect profiles vary among NSAIDs, influencing selection.
Conclusions:
- NSAIDs play a role in cancer pain management, with specific attention to bony metastases.
- Selection criteria should balance efficacy, tolerability, and adverse effect profiles.
- Strategies for improving the safe use of NSAIDs in oncology are essential.