The epidemiology of cancer-related pain

Abstract

Epidemiology, when understood as the study of the distribution and determinants of disease in the population, has three key aspects: frequency, distribution and determinants. Not always the disease is the only relevant factor. At times, the deficiences or symptoms stemming from the pathology weigh in the altering of life quality to such an extent that they become the main point in the person's life. This is what happens in the case of cancer pain. It affects sleep, appetite, physical activity, hygiene, humor, interpersonal relationships, the ability to concentrate, sexual activity, as well as other aspects.There are few, limited epidemiological studies on cancer-related pain that adress frequency of occurrence, characteristics, distribution, and determining factors. Nonetheless, studies carried out 'utilizing groups of patients demonstrate that the frequency with which pain occurs is of such magnitude that the pain control is one of the four priorities of the World Health Organization's (WHO) cancer control program, which considers this subject a public health problem.Pain is the most feared oncology symptom. It may be acuteur chronic. When acute, it generally results from diagnostic or therapeutic actions. When chronic, it is r~lated to the tumor or its metastases in about two-thirds of the cases by bone and neural invasion. Infiltration of the soft tissues, compression or occlusion of the blood vessels, and obstruction of hollow viscera. Aproximately one-fifth of the time pain is the consequence of antineoplastic therapies, such as those associated with actinic lesions. It may be due to increase in nociception stimulation (nociceptive pain), by lesion of the central or peripheral nerve pathways (deafferentation pain), and is frequently due to a combination of these. The occurrenee of cancer pain is due to the caracteristics of the disease itself and to the characteristics of the patient. It is related to the extesion of the disease, the presence of metastases, and the location of the tumor. The patient's cultural and affective aspects and the symbolic significance he attributes to pain also influence. In metastases or advanced loco-regional neoplasiasm between 40% to 95% of the patients feel pain 1. In cases initiating and those without metastasis, frequency is between 11% and 75%. In every phase of the illness, pain~sfelt by 50% of the patients. Traditionaly, pain is through to occur more in bone tumors when it also attacks organs such the pancreas, liver, and lungs, among others, and when the tumor is located in the cephalic segment, in contrast to the leukemias. It is highly possible that the size of the tumor and the involvement of sensitive nerve structures, more than the location of the tumor, has greater influence in the occurence of pain.The influence of the affective state on pain exists. Pain and depression are associated and pain frequency is greater among depressed cancer patients than those who are not.Intensity of cancer pain varies in accord with the location of the tumor, of the metastases, and...

Correlação entre intensidade da dor e incapacidade com as lesões intra-articulares em pacientes com síndrome do impacto femoroacetabular

“…The intensity of the preoperative pain, analyzed using the Visual Analog Pain Scale (VAS), 12 and the preoperative functional ability, analyzed by the Harris Hip Score modified (mHHS) by Byrd, translated and adapted into Portuguese, were considered dependent variables. 13…”

“…It was obtained by drawing a line that crosses the centers of the femoral heads, one perpendicular to that line also passing through the center of the femoral head, and another line at the lateral edge of the acetabulum. 12…”

“…Foram consideradas como variáveis dependentes a intensidade da dor pré-operatória, analisada por meio da Escala Visual Analógica (EVA), 12 e a capacidade funcional pré-operatória, analisada por meio do Harris Hip Score modificado (HHSm) por Byrd, questionário traduzido e adaptado para a língua portuguesa. 13…”

“…Ele foi obtido ao se traçar uma linha que cruza os centros das cabeças femorais, uma perpendicular à essa linha, passando também pelo centro da cabeça femoral, e uma outra linha no rebordo lateral do acetábulo. 12…”