Current Situation
Many studies show that the management of cancer pain is often suboptimal,[18,19] and this is particularly true in elderly patients.[20,21]
A recent European study that focused on the prevalence and treatment of cancer pain has been performed in 11 European countries and Israel in 2006–2007.[22] A total of 5,084 cancer patients were contacted and 56% (573) of them suffered moderate to severe pain at least monthly. The results of this survey challenge the belief that cancer pain is usually well managed. The study found that pain was principally managed by medical oncologists (42%, 242/573). Most patients (72%, 415/573) reported that their clinician asked them about their pain either at most consultations (16%, 95/573) or every consultation (55%, 320/573). Only 15% (88/573) of patients reported that their clinician measured their pain using a pain scale (55%, 320/573). Of 441 patients, 437 reported that they used prescription medications to treat pain. Among these, 24% were taking a step III opioid alone, 12% were taking a step II opioid alone, 7% were taking step II and step III opioids, either together or in combination with non-opioid drugs, and 8% received non-opioid analgesics alone. Eventually, pain was described as distressing by 67% of patients, as an intolerable aspect of their cancer by 36%, and 32% reported that the pain was so bad they wanted to die.
These results indicate that assessment is often poor and treatment and outcomes are often suboptimal. Poor care of cancer pain is clearly unacceptably commonplace in Europe. It is necessary to improve pain management in moderate to severe cancer pain. Knowledge of the different therapeutic options will lead to the development of guidelines for action, enabling us to better manage each situation.
Cancer Chemother Rev. 2009;4(2):95-109. © 2009 P. Permanyer
Cite this: Update in Cancer Pain - Medscape - Apr 01, 2009.
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