Effect of pamidronate on pain control in breast cancer patients

ABSTRACT

One of the common complaints in advanced breast cancer is pain. This is due to osseous metastasis. Analgesics, along with chemotherapy and hormonal therapy, are the mainstay of treatment. Multifocal bone disease that is refractory to above routine treatments can benefit from a series of agents like pamidronate. Design: Prospective comparative study. Place and Duration of Study Study was carried out from February 1998 to January 2001 in the Department of Radiotherapy / Oncology, Services Hospital, Lahore. Subjects and Sixty patients suffering from metastatic breast cancer [mainly to bones] initially treated with chemotherapy or hormonal therapy and analgesics were treated with 60-90 mg of injection pamidronate by 4-hour intravenous infusion once a month for three or more months. The intensity of pain was assessed by the memorial symptom assessment scale and marked on the pain control performa according to frequency of pain, severity of pain or interference in daily activities due to pain at the start and after six months time of incluson in the study. Difference in frequency of pain, severity or interference in daily routine was measured for each patient individually. Marked pain relief was reported by 60% of patients who were additionally taking Pamidronate as compared to 43.3% patients who were not taking pamidronate. Reduction in pain and analgesic demand is noted more in chemotherapy group with pamidronate as compared to hormonal therapy group. Pamidronate can be additionally used in resistant cases for pain control