Efficacy of treatments for pain and numbness in cancer survivors: a systematic review and meta-analysis

Abstract

Background: Pain and numbness in cancer survivors frequently have negative impacts on quality of life (QoL). This meta-analysis aimed to identify the current treatment options for pain and numbness in cancer survivors and to evaluate their effects.Methods: Cancer survivors were defined as patients diagnosed with cancer who had completed active cancer treatment, whose conditions were stable, and who had no evidence of recurrent or progressive disease.A systematic search through the PubMed, MEDLINE, Embase, Cochrane Central Register of Controlled Trials, Web of Science, PsycInfo, and CINAHL databases was conducted, which targeted randomized controlled trials (RCTs) published until April 2022 that evaluated any type of treatment for pain or numbness in cancer survivors. A meta-analysis was conducted using the random-effects model to obtain the effect sizes of 7 types of treatments: opioid therapy, nonopioid pharmacotherapy, interventional therapy, acupuncture, education/cognitive behavioral therapy (CBT), physical exercise, and alternative medicine.Results: A total of 36 studies involving 2,870 cancer survivors were included. Among them, 35 (n=2,813) were included in the meta-analysis for pain. The analysis suggested that physical exercise [n=761; 13 studies;

Managing persistent pain and numbness in cancer survivorship

“…Hospital and National Cancer Center, Tokyo reported the first-ever systematic review and meta-analysis on the efficacy of treatments for pain and numbness in cancer survivors in the December 2022 issues of Annals of Palliative Medicine (12). They assessed 36 randomized controlled trials that evaluated any type of treatment for pain or numbness among 2,870 cancer survivors.…”

“…Patients with active cancer can experience pain directly from their underlying malignancy, whereas survivors can continue to experience pain from their cancer-directed therapies for weeks, months, years or even indefinitely after their cancer treatment (9,10). While narcotics can help alleviate treatment-induced pain, many patients do not use analgesics due to concerns of addiction, cost, or their healthcare providers not recommending the agents (11), they are less commonly prescribed following the completion of cancer therapy (12), and their use has become more controversial in the setting of the ongoing opioid crisis (13). Additionally, chemotherapy-induced peripheral neuropathy can be a debilitating long-term sequala of therapy in cancer survivors and has very few effective treatment options (14,15).…”

Treatment options for persistent pain and numbness in cancer survivors

“…The management of chronic pain and numbness in cancer survivors can pose challenges for healthcare providers. The detailed, systematic review and meta-analysis conducted by Abe and colleagues, "Efficacy of treatments for pain and numbness in cancer survivors: a systematic review and meta-analysis", provides a much-needed critical assessment of treatment modalities including-opioid therapy, nonopioid pharmacotherapy, interventional treatments, acupuncture, education and cognitive behavioral therapy, physical exercise, and alternative medicine-for pain and numbness in cancer survivors (4). In their systematic review, cancer survivors were characterized as being aged 18 years or older, completed active cancer treatment, and were noted to have stable disease with no evidence of recurrence or progression and excluded studies with participants who had greater than 50% advanced cancer, stage III-IV or terminal disease and ongoing active cancer treatment.…”

Pain in cancer survivors: a challenge for the next decade

“…Abe et al recently published (1) article on the effectiveness of pain treatments in cancer survivors is an essential contribution for renewing oncologic patients care.…”

“…At the same time, cancer pain remains a symptom often uncontrolled in these specific oncologic patients and unfortunately often under diagnosed (3,4). In addition, the efficacy of the various analgesic treatments proposed is inconstant, sometimes unsuitable and infrequently evaluated as the Hiroaki article highlights (1).…”