Blood & Cancer Episode 09:
John J. Strouse, MD, PhD, and Julie Kanter, MD, join guest host Ify Osunkwo, MD, of Levine Cancer Institute/Atrium Health in Charlotte, N.C., take a look at some of the thornier issues in sickle cell disease treatment, from caring for young adults to prescribing opioids for pain.
Ilana Yurkiewicz, MD, explores the tight rope cancer patients must walk when they are told to “hope for the best, but prepare for the worst.” Dr. Yurkiewicz is a fellow in hematology and oncology at Stanford University and is a columnist for Hematology News.
BY EMILY BRYER, DO
Resident in the department of internal medicine, University of Pennsylvania Health System.
What is the role of the community hematologist-oncologist or the primary care physician in supporting their disease management?
- Utilize resources, including consults with hematologists, as well as guidelines from the American Society of Hematology and National Heart, Lung, and Blood Institute.
Pain is one of the most disabling symptoms of sickle cell disease.
- Lack of objective criteria for pain poses a challenge to clinicians
- IV opioids are the gold standard for acute sickle cell pain crises
While patients with sickle cell disease have the same condition, they are each affected by it differently. Every individual with sickle cell disease needs to be assessed and treated as an individual.
Providers should look beyond the sickle cell diagnosis when treating pain.
- It is important to differentiate if presenting pain is distinct from typical sickle cell pain
- Ask patients: “Is this pain like your usual pain?”
Psychosocial and emotional status are important components of treating and supporting patients with sickle cell disease.
It is important to establish pain management strategies for patients with sickle cell disease, as well as to clarify pain management strategy and access to care.