Burden of cancer pain in developing countries: a narrative literature review

Abstract

Cancer pain is one of the most common, feared, debilitating, and often undertreated symptoms among cancer patients. It needs attention since it has a significant impact on the quality of life (QoL) of the patients. Also, since cancer has emerged as a major health problem in developing countries, there is a need to strengthen preventive strategies for effective cancer pain management and provide comfort to cancer patients. Nonetheless, various barriers limit developing countries toward optimal cancer pain management. To bridge the gap between adequate pain management and burden of cancer pain in developing countries, a comprehensive understanding of the limitations faced and the prevalence of cancer pain should be addressed. The aim of this literature review is to provide a deeper understanding on the factors associated with cancer pain as well as barriers toward optimal cancer pain management in developing countries. Some of the barriers addressed were administrative, judicial, economic, and professional barriers. Also, estimates on the prevalence of cancer pain and detrimental effects of pain on the QoL of cancer patients have been addressed. In summary, pain, which is one of the most debilitating symptoms of cancer, remains uncontrolled and undertreated in developing countries. It has a profound impact on the patient’s QoL and can have physical, psychological, and social consequences; therefore, it needs to be managed urgently and appropriately. Most importantly, optimal treatment of cancer pain should be highlighted as a priority in developing countries and concerted efforts should be made to eliminate different barriers discussed in this review for effective and humane care.

Managing Pain in People with Cancer—a Systematic Review of the Attitudes and Knowledge of Professionals, Patients, Caregivers and Public

“…These findings are consistent with those of recent studies and systematic reviews [12,13,20,26,37,79,80,96]. Thus, it can be argued that due to these negative attitudes and lack of knowledge towards CPM, the management of cancer pain remains a major problem worldwide, especially in countries within Europe, Africa and Asia [13,26,52,75,76,81,92]. These could be due to lack of education and training about CPM among professionals and lack of general awareness and adequate level of knowledge about CPM among patients, caregivers and the public, as these were stated in all of the included studies.…”

“…Morphine remains the most effective and recommended treatment for CPM [99,103]. Despite the improving quality of pharmacological options for pain management, several studies have revealed that patients at different stages of their disease still do not receive appropriate CPM [3,18,25,37,52,92]. Lack of knowledge and negative attitudes towards Electronic supplementary material The online version of this article (https://doi.org/10.1007/s13187-019-01548-9) contains supplementary material, which is available to authorized users.…”

Oxycodone versus morphine for cancer pain titration: A systematic review and pharmacoeconomic evaluation

“…It is true that there are methodological problems and a plethora of extraneous variables that influence the reliability and validity of studies conducted in pharmacoeconomic area [3]. Some limitations of our study need to be taken into account when interpreting the results.…”

“…developing countries where there are limited research and data [3]. Considering the influence of drug price on results, we attempted to ascertain the impact of parameter variation via alternatives in a one-way sensitivity analysis.…”

“…Pain affects cancer patients at all stages from diagnosis to palliative care and is one of the most feared and burdensome symptoms [1,2]. It has a substantial impact on both the clinical and humanistic burden of cancer, particularly in the developing regions of the world [3]. Moderate to severe pain is experienced by more than one third of patients with advanced cancer [4].…”