Cancer pain syndromes (original) (raw)
Related papers
Pain, 1999
The optimal assessment of cancer pain includes a detailed description of pain characteristics and classi®cation by both syndrome and likely mechanisms. In the clinical setting, the interpretation of this information is aided by knowledge of the available clinical experiences on these aspects of the pain. Unfortunately, existing data are limited. There have been few large surveys of cancer pain characteristics and syndromes, and comparative data from patients in different parts of the world are entirely lacking. To better de®ne the characteristics of cancer pain syndromes the Task Force on Cancer Pain of the International Association for the Study of Pain (IASP) conducted a prospective, crosssectional, international, multicenter survey of pain specialists and their patients. From a total of 100 clinicians who described themselves as cancer pain practitioners in the IASP membership directory, 51 agreed to participate in the survey and a total of 58 provided data. These clinicians resided in 24 countries and evaluated a total of 1095 patients with severe cancer pain mostly requiring opioid medication, using a combination of patient-rated and observer-rated measures. The patient-rated scales comprised a pain intensity measure chosen from the brief pain inventory. The observer-rated information included demographic and tumor-related data, and responses on checklists of pain syndromes and pathophysiologies. Patients were heterogeneous in terms of demographics and tumor-related information. More than 76% had a Karnofsky performance status score # 70. Almost one-quarter of the patients experienced two or more pains. A large majority of the patients (92.5%) had one or more pains caused directly by the cancer; 20.8% of patients had one or more pains caused by cancer therapies. The average (SD) duration of pain was 5.9 (10.5) months. Approximately two-thirds of patients (66.7%) reported that the worst pain intensity during the day prior to the survey was^7 on a 10-point numeric scale. The factors that were univariately associated with higher pain intensity included the presence of breakthrough pain, somatic pain or neuropathic pain, age younger than 60 years, and lower performance status score. A multivariate model suggested that the presence of breakthrough pain, somatic pain, and lower performance status were the most important predictors of intense pain. Pains that were inferred by the treating clinician to be nociceptive and due to somatic injury occurred in 71.6% of the patients. Pains labeled nociceptive visceral were noted in 34.7% and pains inferred to have neuropathic mechanisms occurred in 39.7%. In a broad classi®cation, the major pain syndromes comprised bone or joint lesions (41.7% of patients), visceral lesions (28.1%), soft tissue in®ltration (28.3%), and peripheral nerve injuries (27.8%). Twenty-two types of pain syndromes were most prevalent. Large differences in the diagnosis of breakthrough pain by clinicians of different countries suggest that this phenomenon is either de®ned or recognized differently across countries. These data con®rm, in segment of the cancer population experiencing severe pain, in different parts of the world, that cancer pain characteristics, syndromes and pathophysiologies are very heterogeneous. Predictors of worsening pain can be identi®ed. The data provide a useful context for the interpretation of pain-related information acquired in both clinical and research settings. They suggest the need for future studies and the potential usefulness of a written checklist for cancer pain syndromes and pathophysiologies. q 1999 International Association for the Study of Pain. Published by Elsevier Science B.V.
Cancer Pain: Incompletely Assessed, Inadequately Treated
Cancer therapy & Oncology International Journal
A substantial number of patients with cancer suffer considerable pain at some point during their disease, and approximately 25% of cancer patients die in pain [1]. Cancer pain is prevalent, undertreated, and feared by patients with cancer. The prevalence of pain in cancer patients at various stages of the disease range from 38 to 51%, and increases up to 74% in the advanced and terminal stages. Despite published World Health Organization (WHO) guidelines for pain management, 42 to 51% of cancer patients receive inadequate analgesia and 30% receive no analgesics at all [2,3]. Reasons for under-treating cancer pain include attitudes of patients, clinicians, and factors associated with healthcare systems. Poorly managed cancer pain is well known to profoundly impact the patient's daily life and interfere with quality of life. To manage pain in oncology patients, clinicians should assess pain during regular follow-up visits using validated pain measurement tools and follow prescribing guidelines, if necessary referring patients with cancer to pain specialists. While much "treatment inertia" exists in cancer pain control, cancer pain can be safely and effectively managed and should be carried out to alleviate suffering and improve outcomes [4].
Agonizing Cancer Pain: Effective Interventional Pain Management
Pain is one of the most common symptoms associated with cancer. Pain is defined as "an independent and emotional experience associated with actual or potential tissue damage or described in terms of such damage." Cancer pain or cancer-related pain distinguishes pain experienced by cancer patients from that experienced by patients without malignancies. Pain occurs in approximately one quarter of patients with newly diagnosed malignancies, one third of patients undergoing treatment, and three quarters of patients with advanced disease. In addition, this is one of the symptoms patients fear most. Unrelieved pain denies them comfort and greatly affects their activities, motivation, interactions with family and friends, and overall quality of life. The importance of relieving pain and the availability of excellent therapies make it imperative that physicians and nurses caring for these patients be adept at the assessment and treatment of cancer pain. This requires familiarity with the pathogenesis of cancer pain; pain assessment techniques; common barriers to the delivery of appropriate analgesia; and pertinent pharmacologic, anesthetic, neurosurgical, and behavioral approaches to the treatment of cancer pain.
Principles and Management of Cancer Pain
Palliative care has a critical importance in oncologic treatment and cancer pain treatment is an important part of the palliative care treatment program including physical, social and spiritual components. Most of the patients with cancer experience pain in any stage of their disease therefore pain treatment is a necessity in these patients. On the other hand, studies have shown that there is an insufficient pain treatment in cancer patients due to problems related with physicians or the patients. For this purpose, the principles and management of cancer pain heavily in the light of the current literature was aimed to be evaluated.
Oncologic approach to the treatment of cancerassociated pain
2019
Pain is one of the more common symptoms of malignant disease. It is an extremely unpleasant and frightening symptom that as a rule manifests in more advanced stages of the disease. Due to the nature and spread of tumor disease (incurability), the pain experienced by oncologic patients is frequently of a chronic type. In such conditions, there is no doubt that pain adversely aff ects the patient quality of life. Alongside physical pain, patients suff ering from a malignant disease can also experience mental (emotional) pain. Consequently, the pain felt by oncologic patients is not only a physical experience but a manifestation of a variety of psychological, social and spiritual elements. Th at is why the concept of ‘total pain’ is used. When treating pain, the focus should not be only on the pain itself (physical pain) but also on the person as a whole. Since all the components of pain must be attended, treating oncologic patients very oft en requires a multimodal and multidisciplina...
Treatment and taxonomy of cancer pain: Is there a need for a new approach?
Medicus, 2007
According to the International Association for the Study of Pain, pain is categorized according to: its location, involved organ or tissue system, temporal pattern, intesity and etiology. Cancer pain could not be classified according to etiology and pathophisiology only. A distinct taxonomy of cancer pain is therefore warranted, because a unique group of syndromes, therapies and other etiologies of pain occur in this setting. This paper reviewed a variety of current approaches for the classification of cancer pain. Currently, the World Health Organization (WHO) three-step analgesic ladder is the gold standard for therapy of cancer pain predominatly based on the etiology, pathophysiology and location of the symptoms. As the mechanisms of pain become more evident, especially at the cellular level, perhaps a true mechanistic taxonomy can be developed replacing the three-step ladder with a more complex approach.
Cancer pain as a meaningful aspect of the oncological treatment
2021
Introduction and objective: Pain is the most common and universal symptom among all patients with the oncological disease. Pain significantly reduces the quality of life, hinders decent functioning, and plays a significant role in the deterioration of the mental health of the patient and his close relatives. The study aimed to discuss the mainstreaming of effective pain treatment and to review various assessments and scales (including Brief Pain Inventory, Illness Perception Questionnaire and Numeric Rating Scale) concerning the psychological aspect of pain in selected neoplastic diseases.State of knowledge: We can distinguish various treatments for pain that can be divided into pharmacological and non-pharmacological methods. Latest studies revealed that pain treatment appears to be more and more meaningful. Various factors might influence pain perception and response to the applied treatment. Among all malignancies, special attention is paid to the pain issue in following cancers:...
Pathophysiology of Cancer Related Pain: A Brief Report
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage. Cancer related pain is still permanent, and is feared as problematic worldwide. Cancer pain management is the most problematic when found in patients who have a malignant tumor, and represents the most feared consequences for patients and their families. Cancer related pain management stays a challenge in cancer patients, their families, and oncology nurses due to lack of knowledge and assessment of pain which causes inadequate pain management. There is agreement among experts about the classification of pain into nociceptive, neuropathic, psychogenic, mixed, or idiopathic. This classification is found useful in assessment and therapeutic decision making. Nonetheless, it is now widely accepted that persistent pain may be sustained by different types of mechanisms and experts agree that clinical characteristics can be used to broadly divide pain syndromes into nociceptive, neuropathic, psychogenic, mixed, or idiopathic. Those involved with overlapping cancer related pain should be aware of the barrier of the realization that faces health care providers; thus, they need more studies to further understand the unique molecular mechanisms by which cancer produces sensitization and pain so that new pharmacological targets can be identified that will reduce or block tumor-evoked sensitization.
Pain …, 2010
Jon Raphael, MB, ChB, MSc, FRCA, MD, FFPMRCA,* Sam Ahmedzai, BSc, MB, ChB, FRCP, Joan Hester, MB, BS, FRCA, MSc, FFPMRCA, Catherine Urch, BM, MRCP, PhD,§ Janette Barrie, RN, MSc,¶ John Williams, MB, BS, FRCA, FFPMRCA,** Paul Farquhar-Smith, MB, ...