2.

Knowing that Jane probably has two types of pain due to the metastasis, what adjuvant
might you consider for the bone pain?
Jane is an 84-year-old woman diagnosed with breast cancer 2 years ago, now with metastasis to
the bone and lung. Upon assessment, she confirmed that she experienced 8/10 of pain using pain
scale that is consider as severe pain. According to World Health Organization (WHO) there are a
3-step ladder for pain management in adult cancer patients. This three-step approach of
administering the right drug in the right dose at the right time is inexpensive and 80-90%
effective. For pain management in Jane’s case - an Opioid drug combined with Non-opioid or
Adjuvant drugs to lessen the pain. That is why her oncologist prescribed Hydrocortisone 7.5/750
mg, 1-2 tabs q4 PRN which is an anti-inflammatory (steroid) that relieves inflammation in
various parts of the body. It also treat or prevent allergic reactions. As treatment of certain kinds
of autoimmune diseases, skin conditions, asthma and other lung conditions. The adjuvant that we
might consider to relieve the bone pain she is experiencing is the decadron. It is an anti-
inflammatory medication. It relieves inflammation in various parts of the body. It is used
specifically to decrease swelling (edema), associated with bone metastases. Bone metastases are
a common complication in patients with advanced cancer. It is also given to treat or prevent
allergic reactions. Decadron is classified as a corticosteroid (more precisely a
glucocorticosteroid). Medications known as steroids can often help to relieve pain associated
with bone metastases by decreasing swelling and inflammation around the sites of cancer. These
steroids are different from the types of steroids that bodybuilders or athletes use to build muscle.
Steroids can work quite quickly to help pain and prevent some cancer complications, but they
also must be used very cautiously because they have side effects, especially when used for
prolonged periods. Base on the study, Corticosteroids are commonly prescribed as adjuvant
therapy in the treatment of painful bone metastases in patients with limited life expectancy like
our patient Jane, that has refused any further active treatment. Additional to this, the tapentadol
or opoid such as morphine or oxycodone is a medication used to treat moderate to severe pain. It
can help relieve the pain when other treatment or medication are not enough to relief the pain.