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New developments in the assessment of pain in cancer patients

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Abstract

Pain occurs in more than 80% of cancer patients before death. During recent years major progress has taken place in our techniques for the adequate assessment of cancer pain. Major prognostic factors associated with the pain syndrome have been recognized. In addition, other prognostic factors associated with the characteristics of the patient have been defined. Valid tools have been developed that allow for the assessment of most of the prognostic variables associated with analgesic response. During recent years a major effort has been made to integrate the pain syndrome within the other complex symptoms that are often present in patients with advanced cancer. The interaction of pain and analgesic treatment with other symptoms and their management is discussed. Finally, areas where future research should focus in the area of the diagnosis and assessment of pain are discussed.

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References

  1. Ahles TA, Blanchard EB, Ruckdeschel JC (1983) The multidimensional nature of cancer-related pain. Pain 17:277–288

    Google Scholar 

  2. American Joint Committee for Cancer Staging and End Result Reporting (1977) Manual for staging of cancer. Am Joint Committee, Chicago, Ill

    Google Scholar 

  3. Arner S, Meyerson BA (1988) Lack of analgesic effect of opioids on neuropathic and idiopathic forms of pain. Pain 33:11–33

    Google Scholar 

  4. Banning A, Stugren P, Henriksen H (1991) Treatment outcome in a multidisciplinary cancer pain clinic. Pain 47:129–134

    Google Scholar 

  5. Begent R, Bagshawe K (1982) Management of high risk choriocarcinoma. Semin Oncol 9:198–203

    Google Scholar 

  6. Bruera E, Chadwick S, Brenneis C, Michaud M, Bacovsky R, Emeno A, MacDonald RN (1988) Use of the subcutaneous route for the administration of narcotics in patients with cancer pain. Cancer 62:407–411

    Google Scholar 

  7. Bruera E, Brenneis C, Michaud M, MacDonald RN (1989) Influence of the Pain and Symptom Control Team (PSCT) on the patterns of treatment of pain and other symptoms in a cancer center. J Pain Symptom Manage 4:112–116

    Google Scholar 

  8. Bruera E, Macmillan K, Hanson J, MacDonald RN (1989) The Edmonton Staging System for Cancer Pain: preliminary report. Pain 37:203–209

    Google Scholar 

  9. Bruera P, Kuehn N, Miller MJ, Selmser P, Macmillan K (1991) The Edmonton Symptom Assessment System (ESAS): a simple method for the assessment of palliative care patients. J Palliat Care 7:6–9

    Google Scholar 

  10. Bruera E, Schoeller MT, Wenk R, Macmillan K, et al (1991) The Edmonton Staging System (ESS) for cancer pain: a prospective multicenter study (abstract 1144). Proc ASCO 10:27

    Google Scholar 

  11. Coyle N, Adelhardt J, Foley KM (1987) Changing patterns in pain, drug use and routes of administration in the advanced cancer patient. Presented at the 5th World Congress on Pain of the International Association for the Study of Pain, Marburg, Germany

  12. Coyle N, Adelhardt J, Foley KM, et al (1990) Character of terminal illness in the advanced cancer patient: pain and other symptoms during the last four weeks of life. J Pain Symptom Manage 5:83–93

    Google Scholar 

  13. Dubner R (1991) A call for more science, not more rhetoric, regarding opioids and neuropathic pain (editorial). Pain 44:1

    Google Scholar 

  14. Fainsinger R, Bruera E, Miller MJ, Hanson J, MacEachern T (1991) Symptom control during the last week of life on a palliative care unit. J Palliat Care 7:5–11

    Google Scholar 

  15. Fishman B, Pasternak S, Wallenstein SL, et al (1987) The Memorial Pain Assessment Card. A valid instrument for the evaluation of cancer pain. Cancer 60:1151–1158

    Google Scholar 

  16. Foley K (1985) The treatment of cancer pain. N Engl J Med 313:84–95

    Google Scholar 

  17. Folstein MF, Folstein S, McHugh PR (1975) “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Google Scholar 

  18. Grond S, Zech D, Schug SA, et al (1991) Validation of World Health Organization Guidelines for cancer pain relief during the last days and hours of life. J Pain Symptom Manage 6:411–422

    Google Scholar 

  19. IASP Subcommittee on Taxonomy (1986) Classification of chronic pain. Pain [Suppl] 3:S1-S225

    Google Scholar 

  20. Lamerton R (1980) Care of the dying. Penguin, New York

    Google Scholar 

  21. Macaluso C, Weinberg D, Foley KM (1988) Opioid abuse and misuse in a cancer pain population. J Pain Symptom Manage 3:S24

    Google Scholar 

  22. Marks R, Sachar E (1973) Undertreatment of medical in-patients with narcotic analgesics. Ann Intern Med 78:173–181

    Google Scholar 

  23. Mount B (1979) Medical applications of heroin. Can Med Assoc J 120:405–407

    Google Scholar 

  24. Minister of Supply and Services Canada (1984) Cancer pain. A monograph on the management of cancer pain. Health and Welfare Canada. Ottawa, H42-2/5

    Google Scholar 

  25. Paterson AHG (1988) Clinical staging and its prognostic significance. In: Stall B (ed) Pointers to cancer prognosis. Nijhoff, Dordrecht, pp 37–48

    Google Scholar 

  26. Portenoy RK, Coyle N (1990) Controversies in the long-term management of analgesic therapy in patients with advanced cancer. J Pain Symptom Manage 5:307–319

    Google Scholar 

  27. Portenoy RK, Hagen NA (1990) Breakthrough pain definition, prevalence and characteristics. Pain 41:273–281

    Google Scholar 

  28. Portenoy RK, Foley KM, Inturrisi CE (1990) The nature of opioid responsiveness and its implications for neuropathic pain: new hypotheses derived from studied of opioid infusion. Pain 43:273–286

    Google Scholar 

  29. Swerdlow M, Stjernsward J (1980) Cancer pain relief — an urgent problem. World Health. Forum 3:325–330

    Google Scholar 

  30. Twycross R (1984) Opioids. In: Wall P, Melzack R (eds) Textbook of pain. Churchill Livingstone, Edinburgh, pp 686–701

    Google Scholar 

  31. Valagussa P, Bonadonna G, Veronesi V (1978) Patterns of relapse and survival following radical mastectomy. Cancer 41:1170–1178

    Google Scholar 

  32. Ventafridda V, Caraceni A (1991) Cancer pain classification: a controversial issue. Pain 46:1–2

    Google Scholar 

  33. Ventafridda V, Ripamonti C, DeConnoF, et al (1990) Symptom prevalence and control during cancer patients' last days of life. J Palliat Care 6:7–11

    Google Scholar 

  34. WHO (1990) Cancer pain relief and palliative care. (WHO technical report series 804) World Health Organization, Geneva

    Google Scholar 

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Authors and Affiliations

  1. Palliative Care Program, Edmonton General Hospital, 11111 Jasper Avenue, 15K 0L4, Edmonton, Aiberta, Canada

    F. Bruera M. D. & S. Watanabe M. D.

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  1. F. Bruera M. D.
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  2. S. Watanabe M. D.
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Bruera, F., Watanabe, S. New developments in the assessment of pain in cancer patients. Support Care Cancer 2, 312–318 (1994). https://doi.org/10.1007/BF00365585

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