Cancer Pain and Frailty: A Scoping Review of How Cancer Pain Is Evaluated and Treated in the Frail and Elderly

Abstract

Background: Over 50% of individuals with cancer will experience pain at some point from diagnosis to treatment. Many of these individuals are elderly and frail, further complicating their pain management. The purpose of this review is to synthesize what is known about the assessment and management of cancer pain in the frail, elderly individual. Methods: A scoping review was undertaken using the methodology outlined by Arksey and O'Malley with reporting as defined by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews. Three databases were searched for articles that met our inclusion criteria and resulted in a total of 2007 articles of which 6 were ultimately included in our review. Results: Of the 6 studies included 5 focused on individual related characteristics and 1 study focused on provider factors. These studies found that frail and elderly individuals with cancer are at risk of unmanaged pain and polypharmacy; however, the prevalence remains unclear. Additionally, treatment of cancer pain in this population is impacted by clinicians' backgrounds and comfort levels in pain assessments. Discussion: The frail, elderly individual with cancer is at risk for pain. Little is currently known about how to accurately measure and safely treat pain in this population.