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Old 06-06-2009, 09:07 PM   #1
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Morphine vs Duragesic patch (fentanyl) for cancer pain

Dear All,

My sister is having bone cancer (chondrasarcoma) in pelvis for last 4 years. Cancer is in advanced stage now and she is completely on pain-killers. It is a slow growing tumor growing in pelvis and surrounding areas.

She has been taking Ultracet (37.5 mg tramadol+ 325 mg acetaphenomin) for 2 years. Currently she is taking around 5 Ultacet tablets a day but still does not get pain relief. She is also taking some anti-depressents.

Now doctors are suggesting to start narcotics drugs like morphine/duragesic patches.

What will be good among morphine and duragesic (fentanyl)? Her pain is typical cancer pain (due to growing tumor and nerves getting pressed) and is there round the clock.

Is there any other better altnernative then morphine and durageisc.


Thanks & Best Regards,
Naresh Agarwal (from India)

 
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Old 06-06-2009, 10:45 PM   #2
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

Quote:
Originally Posted by nareshka View Post
Her pain is typical cancer pain (due to growing tumor and nerves getting pressed) and is there round the clock.

Is there any other better altnernative then morphine and durageisc.
Welcome to Healthboards I'm very sorry to hear about your sister.

Yes, there are many alternatives to morphine and the Duragesic Patch. The med your sister is on now, is at the bottom of the totem pole in terms of strength. Morphine and the patch are quite a ways up from that. There are many meds in between.

What it comes down to is how much pain your sister is in. Pain is usually rated on a pain scale of 1-10, with 10 being the worst pain you can imagine. Most people's pain varies, depending on flair ups & etc. It would be practially impossible for me (or anyone) to suggest a particular med....Again, it's all based on how much pain someone is in. Hopefully, her Doctor is very compassionate and will treat her pain accordingly. Personally, I wouldn't get too caught up in a specific med, but rather if she is comfortable or not.

If her pain is constant, then some type of long acting med may be appropriate and then another med for BT (break thru) or flair ups, if needed.

Take care, and all the best for your sister.

Regards,

Ex

 
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Old 06-07-2009, 04:42 PM   #3
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

I also agree to not get hung up on what specific medication is needed but rather that it is something that gives your sister good pain relief. I would think that it definitely be a long acting (LA) pain medication. There are several different kids of long acting pain medications including:

morphine-based - MS Contin, Kadian, Avinza

oxycodone based - Oxycontin

fentanyl based - fentanyl patch, fentanyl losenges & suckers

Methadone

I would go with your sister to her doctor and tell the doctor that she really is not getting good pain relief. Good luck and let us know what happens.

brian

 
Old 06-07-2009, 04:47 PM   #4
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

The doctors are the best people to decide about which is the best medication. I find it usually boils down to some people do better with the morphine type medications and some do better with the fentanyl. I do not have cancer but do have lots of nerve pain and I find the fentanyl works well, it is pretty easy to use, and I don't feel like I do when I take morphine (which completely makes be naseous, sleepy, out of it). I believe I read the fentanyl patch was developed for cancer patients originally and then dispersed into the pain community for other uses.

I am sorry your family is going through this and prayers for your sister to have comfortable days.

 
Old 06-07-2009, 09:44 PM   #5
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

Quote:
Originally Posted by brianpain33 View Post

fentanyl based - fentanyl patch, fentanyl losenges & suckers
Just a quick point of clarification....The Fentanyl lozenges and lollipops are both short acting.....In fact, very short acting....In quick and out quick...Fastest on the market. Onset for Actiq is 2-3 minutes; peak plasma level is 20 minutes, and half life is 2 hours. Fentora is even faster.

Regards,

Ex

 
Old 06-08-2009, 08:49 AM   #6
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

Narshka,

I am so sorry that your sister is this ill. I second the recommendation that you or another family member go with her to her next appointment. It will help to have a family member there to help let the Dr. know how much pain she is in. If she is able, it may help for her to record her pain levels between now and her next appointment. That will help the Dr. decide how strong a medication to put her on, and at what dosage. It may take a few weeks for the Dr. to get the dosage to where your sister is comfortable.

Tigg.

 
Old 06-08-2009, 03:15 PM   #7
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Re: Morphine vs Duragesic patch (fentanyl) for cancer pain

Yes this is true Ex. I should have pointed that out. I know that people that have bad cancer pain that they will give them the losenges or suckers for the breakthrough pain. Of course the person needs to be on something long acting too.

brian

 
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