About this Research Topic
Cancers of woman's reproductive organs is called gynecologic cancers. The five main types of gynecologic cancer are: cervical, ovarian, uterine, vaginal, vulvar and as a very rare site fallopian tube cancer. As a common site of Gynecologic Cancer, Ovarian cancer is a type of cancer that is usually diagnosed at an advanced stage, frequently recurs, and is extremely difficult to treat due to frequent chemotherapy resistance. Patients with ovarian cancer are usually diagnosed in advanced stages and the 5-year survival rate is less than 40%. Persistent recurrences due to treatment resistance and gastrointestinal disturbances like bloating, constipation, change in bladder function, and difficulty eating caused by intra-abdominal metastases that occur shortly after cancer develops affect the quality of life of patients more than other types of cancer. These problems cause ovarian cancer to be the deadliest cancer type among gynaecological cancer types. The absence of specific and sensitive biomarkers that will enable the early diagnosis of ovarian cancer causes the diagnosis to be detected in advanced stages. One of the important problems in advanced ovarian cancer is that patients have to struggle with prolonged pain. Therefore, differences in clinical stage and treatment protocols in ovarian cancer cause patients to feel different degrees of pain. The prognostic and predictive role of pain in the treatment of ovarian cancer is increasing day by day.
This research topic, which will be held during Gynaecological Cancers Awareness Month, will touch on the subject of constant pain, which is caused by frequent recurrences and metastases, which seriously affects the comfort of the life of the patient. Prolonged pain management is one of the most important factors that complicate the treatment of the disease and affects the survival of the disease, starting with eating difficulties and continuing with gastrointestinal dysfunctions. The discovery of new biomarkers and the development of treatment strategies for these new targets will prevent the deterioration of living standards in ovarian cancer and will lead to life comfort. It will also guide the clinic with new approaches to be provided in the follow-up of pain management.
Gynecologic oncologists encounter patients with a variety of pain sources, including acute and chronic pain. Our patients may experience acute pain due to disease burden or cancer treatments. Due to developing treatment modalities our patients are living longer, with or without active disease, which make cause frequently develop chronic pain either as a result of previous treatments or disease burden. In modern era gynaecologic oncologists should be familiar with pharmacologic and non-pharmacologic methods of treating both acute and chronic pain.
In different meta-analysis studies, no concrete evidence has been obtained that opioids are as effective and reliable in cancer pain as thought. A Cochrane meta-analysis examined the use of all opioids in cancer pain and concluded that "the amount and quality of evidence for the use of opioids in the treatment of cancer pain is disappointingly low. We should consider the effect opioid defenders and abuse. The NCCN confirms the role of opioids in their guidelines for the treatment of cancer pain stating that opioids should be used upfront for moderate to severe pain and non-opioid pain medications are recommended as adjuncts to opioids.
Cancer and its treatments can cause nerve damage or altered nerve function resulting in neuropathic pain. Gabapentin is an antiepileptic/anticonvulsant that suppresses neuronal sensitivity and is commonly used to treat non-cancer related neuropathic pain. Pregabalin is a different antiepileptic/anticonvulsant medication that can be used to treat neuropathic cancer pain. The strongest evidence for the use of pregabalin comes from two prospective randomized trials.
Based on the limited number of studies examining anticonvulsants in neuropathic cancer pain, it seems reasonable to begin treatment with pregabalin or gabapentin as adjuvant medications alone or in addition to existing opioid regimens in gynecologic oncology patients. Melatonin has antinociceptive effects and appears to be useful in treating neuropathic pain. In addition to treating psychiatric disorders, Quetiapine (Seroquel) has anti-inflammatory effects and may be beneficial in treating cancer pain and disordered sleep. Local analgesia is an important option for patients with the use of topical ketamine and Toradol creams helpful for treating chemotherapy induced peripheral neuropathy.
We welcome the submission of manuscripts including, but not limited to, the following topics:
1. The pain-increasing effect of PARP inhibitors used in homologous recombination repair deficiency.
2. Treatment approaches to gastrointestinal dysfunction in ovarian cancer.
3. The effect of preventive medicine, screening methods and frequency, and the preference of risk-reducing medical methods on pain management, especially in families with a genetic predisposition to prevent ovarian cancer and provide early diagnosis. (When the disease, which is one of the main causes of pain in gynecological cancers in locally advanced disease, is detected at an earlier stage, surgery will be easier and treatments will be more effective and comfortable as the disease burden is lower. Therefore, pain due to treatment and tumor burden will be prevented.)
4. The effect of pain-reducing treatment approaches on fertility in early-age ovarian cancer patients.
5. Radiation treatment for pain caused by primary or metastatic site.(bone metastasis, cranial metastasis)
6. Chemothreapy palliation that we can treat.
7. Use of all relevant antidepressants, opioids and non-steroid NSAI for relief of Chemotherapy-related pain treatment (CIPN) neuropathy.
8. Neuromodulation can also help decreasing pain levels and improving quality of life.
9. Medical management of cancer symptoms such as nausea, depression, bleeding, and dyspnea can also help us control cancer-related pain.
10. Stereotactic radiotherapy in ovarian cancer critical oligoprogression during PARP inhibitors maintenance therapy
This research topic, which will be held during Gynaecological Cancers Awareness Month, will touch on the subject of constant pain, which is caused by frequent recurrences and metastases, which seriously affects the comfort of the life of the patient. Prolonged pain management is one of the most important factors that complicate the treatment of the disease and affects the survival of the disease, starting with eating difficulties and continuing with gastrointestinal dysfunctions. The discovery of new biomarkers and the development of treatment strategies for these new targets will prevent the deterioration of living standards in ovarian cancer and will lead to life comfort. It will also guide the clinic with new approaches to be provided in the follow-up of pain management.
Gynecologic oncologists encounter patients with a variety of pain sources, including acute and chronic pain. Our patients may experience acute pain due to disease burden or cancer treatments. Due to developing treatment modalities our patients are living longer, with or without active disease, which make cause frequently develop chronic pain either as a result of previous treatments or disease burden. In modern era gynaecologic oncologists should be familiar with pharmacologic and non-pharmacologic methods of treating both acute and chronic pain.
In different meta-analysis studies, no concrete evidence has been obtained that opioids are as effective and reliable in cancer pain as thought. A Cochrane meta-analysis examined the use of all opioids in cancer pain and concluded that "the amount and quality of evidence for the use of opioids in the treatment of cancer pain is disappointingly low. We should consider the effect opioid defenders and abuse. The NCCN confirms the role of opioids in their guidelines for the treatment of cancer pain stating that opioids should be used upfront for moderate to severe pain and non-opioid pain medications are recommended as adjuncts to opioids.
Cancer and its treatments can cause nerve damage or altered nerve function resulting in neuropathic pain. Gabapentin is an antiepileptic/anticonvulsant that suppresses neuronal sensitivity and is commonly used to treat non-cancer related neuropathic pain. Pregabalin is a different antiepileptic/anticonvulsant medication that can be used to treat neuropathic cancer pain. The strongest evidence for the use of pregabalin comes from two prospective randomized trials.
Based on the limited number of studies examining anticonvulsants in neuropathic cancer pain, it seems reasonable to begin treatment with pregabalin or gabapentin as adjuvant medications alone or in addition to existing opioid regimens in gynecologic oncology patients. Melatonin has antinociceptive effects and appears to be useful in treating neuropathic pain. In addition to treating psychiatric disorders, Quetiapine (Seroquel) has anti-inflammatory effects and may be beneficial in treating cancer pain and disordered sleep. Local analgesia is an important option for patients with the use of topical ketamine and Toradol creams helpful for treating chemotherapy induced peripheral neuropathy.
We welcome the submission of manuscripts including, but not limited to, the following topics:
1. The pain-increasing effect of PARP inhibitors used in homologous recombination repair deficiency.
2. Treatment approaches to gastrointestinal dysfunction in ovarian cancer.
3. The effect of preventive medicine, screening methods and frequency, and the preference of risk-reducing medical methods on pain management, especially in families with a genetic predisposition to prevent ovarian cancer and provide early diagnosis. (When the disease, which is one of the main causes of pain in gynecological cancers in locally advanced disease, is detected at an earlier stage, surgery will be easier and treatments will be more effective and comfortable as the disease burden is lower. Therefore, pain due to treatment and tumor burden will be prevented.)
4. The effect of pain-reducing treatment approaches on fertility in early-age ovarian cancer patients.
5. Radiation treatment for pain caused by primary or metastatic site.(bone metastasis, cranial metastasis)
6. Chemothreapy palliation that we can treat.
7. Use of all relevant antidepressants, opioids and non-steroid NSAI for relief of Chemotherapy-related pain treatment (CIPN) neuropathy.
8. Neuromodulation can also help decreasing pain levels and improving quality of life.
9. Medical management of cancer symptoms such as nausea, depression, bleeding, and dyspnea can also help us control cancer-related pain.
10. Stereotactic radiotherapy in ovarian cancer critical oligoprogression during PARP inhibitors maintenance therapy
Keywords: Gynecologic Cancer, Ovarian Cancer
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