2 research outputs found
Osteonecrosis of the jaw associated with intravenous administration of bisphosphonates in palliative home care a case report
Osteonecrosis of the jaw is an uncommon side effect of bisphosphonates that are used in patients
with bone metastases. The paper presents a case of a patient with breast cancer and numerous
bone metastases, who received an intravenous infusion of zoledronic acid every 28 days for
4.5 years. The indication for the administration of bisphosphonates was the prevention of bone
complications. The patient was diagnosed with osteonecrosis of the jaw associated with the administration
of zoledronic acid and underwent surgical treatment. In this article, we pointed out
the necessity of sanitation of the oral cavity before administration of oncological doses of bisphosphonates,
repeated dentist control, and self-examination of teeth condition during the bisphosphonate
treatment, as well as reduction of risk factors, in order to prevent osteonecrosis of the jaw
Opioid-Induced Sexual Dysfunction in Cancer Patients
Sexual dysfunction is common in patients with advanced cancer, although it is frequently belittled, and thus consistently underdiagnosed and untreated. Opioid analgesics remain fundamental and are widely used in cancer pain treatment. However, they affect sexual functions primarily due to their action on the hypothalamus–pituitary–gonadal axis. Other mechanisms such as the impact on the central and peripheral nervous systems are also possible. The opioid-induced sexual dysfunction includes erectile dysfunction, lack of desire and arousal, orgasmic disorder, and lowered overall sexual satisfaction. Around half of the individuals taking opioids chronically may be affected by sexual dysfunction. The relative risk of sexual dysfunction in patients on chronic opioid therapy and opioid addicts increased two-fold in a large meta-analysis. Opioids differ in their potential to induce sexual dysfunctions. Partial agonists and short-acting opioids may likely cause sexual dysfunction to a lesser extent. Few pharmaceutical therapies proved effective: testosterone replacement therapy, PDE5 inhibitors, bupropion, trazodone, opioid antagonists, and plant-derived medicines such as Rosa damascena and ginseng. Non-pharmacological options, such as psychosexual or physical therapies, should also be considered. However, the evidence is scarce and projected primarily from non-cancer populations, including opioid addicts. Further research is necessary to explore the problem of sexuality in cancer patients and the role of opioids in inducing sexual dysfunction