Abstract
Cancer pain management is a major element of successful cancer survivorship. Regardless of where someone is along the cancer experience, from a newly diagnosed patient to long-term survivor, pain is a potential treatment-related effect that can have a significant impact on a survivor’s life. Quality pain management for cancer survivors is complicated by the fact that cancer-related pain can be due to the tumor, surgery, radiation, and/or chemotherapy. Additionally, the pain experience is related to many psychosocial/spiritual factors. Despite almost 40 years of attention devoted to improving cancer pain management, many cancer survivors are less than optimally treated, often owing to survivor and healthcare provider knowledge barriers. This article reviews some of the latest research related to cancer pain management treatment options, measurement/assessment, and interventions. Progress has been made in understanding new aspects of the pain experience, but more work is yet to be done.
Similar content being viewed by others
References
Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance
Doorenbos AZ, Berger AM, Brohard-Holbert C, Eaton L, Kozachik S, LoBiondo-Wood G, et al. 2008 ONS research priorities survey. Oncol Nurs Forum. 2008;35:E100–7.
National Cancer Institute. Pain (PDQ) - Health Professional Version. 2013. Available at: http://www.cancer.gov/cancertopics/pdq/supportivecare/pain/HealthProfessional. Accessed 1 Oct 2013.
American Cancer Society. Cancer treatment and survivorhsip facts & figures 2012–2013. Atlanta: American Cancer Society; 2012.
Institute of Medicine. Relieving pain in America: a blueprint for transforming prevention, care, education, and research. Washington, DC: The National Academies Press; 2011.
Sessle B. Unrelieved pain: a crisis. Pain Res Manag. 2011;16:416–20.
Schreiber JA. We’ve come a long way…cancer pain management review: oncology Nursing Forum/Newsletter 1973–2013. Oncol Nurs Forum. 2013;40:106–8.
Dunham M, Ingleton C, Ryan T, Gott M. A narrative literature review of older people's cancer pain experience. J Clin Nurs. 2013;22:2100–13.
Pizzo PA, Clark NM. Alleviating suffering 101—pain relief in the United States. N Engl J Med. 2012;366:197–9.
Bredlau AL, Thakur R, Korones DN, Dworki RH. Ketamine for pain in adults and children with cancer: a systematic review and synthesis of the literature. Pain Med. 2014;14:505–17. This review is the first on the use of ketamine in adult and pediatric cancer patients. Findings are limited owing to the variability of the dosing and routes in the studies reviewed.
Hardy J, Quinn S, Fazekas B, Plummer J, Eckermann S, Agar M, et al. Randomized, double-blind, placebo-controlled study to assess the efficacy and toxicity of subcutaneous ketamine in the management of cancer pain. J Clin Oncol. 2012;30:3611–7.
Bell RF, Eccleston C, Kalso EA. Ketamine as an adjuvant to opioids for cancer pain. Cochrane Database Syst Rev. 2012;11, CD003351.
Prommer EE. Ketamine for pain: an update of uses in palliative care. J Palliat Med. 2012;15:474–83.
Soto E, Stewart DR, Mannes AJ, Ruppert SL, Baker K, Zlott D, et al. Oral ketamine in the palliative care setting: a review of the literature and case report of a patient with neurofibromatosis type 1 and glomus tumor-associated complex regional pain syndrome. Am J Hosp Palliat Med. 2012;29:308–17.
Salas S, Frasca M, Planchet-Barraud B, Burucoa B, Pascal M, Lapiana J-M, et al. Ketamine analgesic effect by continuous intravenous infusion in refractory cancer pain: considerations about the clinical research in palliative care. J Palliat Med. 2012;15:287–93.
Macario A, Royal MA. A literature review of randomized clinical trials of intravenous acetaminophen (paracetamol) for acute postoperative pain. Pain Pract. 2011;11:290–6.
Nabal M, Librada S, Redondo MJ, Pigni A, Brunelli C, Caraceni A. The role of paracetamol and nonsteroidal anti-inflammatory drugs in addition to WHO Step III opioids in the control of pain in advanced cancer. A systematic review of the literature. Palliat Med. 2012;26:305–12.
Hadley G, Derry S, Moore RA, Wiffen PJ. Transdermal fentanyl for cancer pain. Cochrane Database Syst Rev. 2013;10, CD010270.
Jandhyala R, Fullarton JR, Bennett MI. Efficacy of rapid-onset oral fentanyl formulations vs. oral morphine for cancer-related breakthrough pain: a meta-analysis of comparative trials. J Pain Symptom Manag. 2013;46:573–80.
Zeppetella G, Davies A, Eijgelshoven I, Jansen JP. A network meta-analysis of the efficacy of opioid analgesics for the management of breakthrough cancer pain episodes. J Pain Symptom Manag. 2014;47:772–85.
Guitart J, Vargas I, Sanctis V, Ferreras J, Fuentes J, Salazar R, et al. Efficacy and safety of sublingual fentanyl orally disintegrating tablets in patients with breakthrough pain: multicentre prospective study. Clin Drug Investig. 2013;33:675–83.
Taylor DR. Single-does fentanyl sublingual spry for breakthrough cancer pain. Clin Pharmacol. 2013;5:131–41.
Velázquez Rivera I, Muñoz Garrido J, García Velasco P, España Ximénez de Enciso I, Velázquez Clavarana L. Efficacy of sublingual fentanyl vs. oral morphine for cancer-related breakthrough pain. Adv Ther. 2014;31:107–17.
Mercadante S, Porzio G, Aielli F, Averna L, Ficorella C, Casuccio A. The use of fentanyl buccal tablets for breakthrough pain by using doses proportional to opioid basal regimen in a home care setting. Support Care Cancer. 2013;21:2335–9.
Webster LR, Slevin KA, Narayana A, Earl CQ, Yang R. Fentanyl buccal tablet compared with immediate-release oxycodone for the management of breakthrough pain in opioid-tolerant patients with chronic cancer and noncancer pain: a randomized, double-blind, crossover study followed by a 12-week open-label phase to evaluate patient outcomes. Pain Med. 2013;14:1332–45.
Mercadante S, Prestia G, Adile C, Casuccio A. Intranasal fentanyl (INFS) versus fentanyl pectyn nasal spray (FPNS) for the management breakthrough cancer pain in doses proportional to basal opioid regimen. J Pain. 2014;15:602–7.
Kongsgaard U, Eeg M, Greisen H. The use of Instanyl® in the treatment of breakthrough pain in cancer patients: a 3-month observational, prospective, cohort study. Support Care Cancer. 2014:1–8.
Rhee YO, Kim E, Kim B. Assessment of pain and analgesic use in African American cancer patients: factors related to adherence to analgesics. J Immigr Minor Health. 2012;14:1045–51.
Schreiber JA, Cantrell D, Moe KA, Hench J, McKinney E, Preston Lewis C, et al. Improving knowledge, assessment, and attitudes related to pain management: evaluation of an intervention. Pain Manag Nurs. 2014;5:474–81.
Modesto-Lowe V, Girard L, Chaplin M. Cancer pain in the opioid-addicted patient: can we treat it right? J Opioid Manag. 2012;8:167–75. This review focuses on adequate cancer pain management strategies in opiod-addicted cancer paitents.
Samuels JG. Abstracting pain management documentation from the electronic medical record: comparison of three hospitals. Appl Nurs Res. 2012;25:89–94.
Ngamkham S, Vincent C, Finnegan L, Holden JE, Wang ZJ, Wilkie DJ. The McGill Pain Questionnaire as a multidimensional measure in people with cancer: an integrative review. Pain Manag Nurs. 2012;13:27–51.
Zhu J, Davis RB, Stuver SO, Berry DL, Block S, Weeks JC, et al. A longitudinal study of pain variability and its correlates in ambulatory patients with advanced stage cancer. Cancer. 2012;118:6278–86.
Hovind IL, Bredal IS, Dihle A. Women’s experience of acute and chronic pain following breast cancer surgery. J Clin Nurs. 2013;22:1044–52.
Knudsen AK, Aass N, Heitzer E, Klepstad P, Hjermstad MJ, Schippinger W, et al. Interviews with patients with advanced cancer—another step towards an international cancer pain classification system. Support Care Cancer. 2012;20:2491–500. Although a small sample of patients, the differences in patients’ ranking of pain domains compared to healthcare professionals is noteworthy.
Al Khalaileh M, Al Qadire M. Barriers to cancer pain management: Jordanian nurses’ perspectives. Int J Palliat Nurs. 2012;18:535–6.
Jablonski K, Duke G. Pain management in persons who are terminally ill in rural acute care. J Hosp Palliat Nurs. 2012;14:533–40.
Rustoen T, Geerling JI, Pappa T, Rundstrom C, Weisse I, Williams SC, et al. A European survey of oncology nurse breakthrough cancer pain practices. Eur J Oncol Nurs. 2013;17:95–100. This RCT did not find a difference between an extended (10-week) pain management program and standard care in decreasing pain intensity.
Yoong J, Traeger LN, Gallagher ER, Pirl WF, Greer JA, Temel JS. A pilot study to investigate adherence to long-acting opioids among patients with advanced lung cancer. J Palliat Med. 2013;16:391–6.
Ling CC, Lui LY, So WK. Do educational interventions improve cancer patients’ quality of life and reduce pain intensity? Quantitative systematic review. J Adv Nurs. 2012;68:511–20.
Tse MM, Wong AC, Ng HN, Lee HY, Chong MH, Leung WY. The effect of a pain management program on patients with cancer pain. Cancer Nurs. 2012;35:438–46.
Koller A, Miaskowski C, De Geest S, Opitz O, Spichiger E. Supporting self-management of pain in cancer patients: methods and lessons learned from a randomized controlled pilot study. Eur J Oncol Nurs. 2013;17:1–8.
Rustoen T, Valeberg BT, Kolstad E, Wist E, Paul S, Miaskowski C. A randomized clinical trial of the efficacy of a self-care intervention to improve cancer pain management. Cancer Nurs. 2014;37:34–43.
Rustoen T, Valeberg BT, Kolstad E, Wist E, Paul S, Miaskowski C. The PRO-SELF© Pain Control Program improves patients’ knowledge of cancer pain management. J Pain Symptom Manag. 2012;44:321–30.
Compliance with Ethics Guidelines
Conflict of Interest
Dr. Judith Schreiber declares no potential conflicts of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
Author information
Authors and Affiliations
Corresponding author
Additional information
This article is part of the Topical Collection on Cancer Pain
Rights and permissions
About this article
Cite this article
Schreiber, J.A. Understanding the Cancer Pain Experience. Curr Pain Headache Rep 18, 440 (2014). https://doi.org/10.1007/s11916-014-0440-5
Published:
DOI: https://doi.org/10.1007/s11916-014-0440-5