Living systematic review to assess the analgesic undertreatment in cancer patients

Roberto, Anna; Greco, Maria; Uggeri, Sara; Cavuto, Silvio; Deandrea, Silvia; Corli, Oscar; Apolone, Giovanni

doi:10.1111/papr.13098

Cited by 28 publications

(18 citation statements)

References 73 publications

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“…Furthermore, in line with our results, previous research on the prevalence of undertreatment of pain in cancer patients indicate that undertreatment of pain decreased over time [320][321][322]. In 2008 and 2014, two systematic literature reviews were published in which the prevalence of undertreatment of pain in cancer patients was 43% and 32%, respectively [320,321].…”

Section: Discussionsupporting

confidence: 90%

Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis

Snijders

Brom

Theunissen

et al. 2023

Cancers

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Experiencing pain and insufficient relief can be devastating and negatively affect a patient’s quality of life. Developments in oncology such as new treatments and adjusted pain management guidelines may have influenced the prevalence of cancer pain and severity in patients. This review aims to provide an overview of the prevalence and severity of pain in cancer patients in the 2014–2021 literature period. A systematic literature search was performed using the databases PubMed, Embase, CINAHL, and Cochrane. Titles and abstracts were screened, and full texts were evaluated and assessed on methodological quality. A meta-analysis was performed on the pooled prevalence and severity rates. A meta-regression analysis was used to explore differences between treatment groups. We identified 10,637 studies, of which 444 studies were included. The overall prevalence of pain was 44.5%. Moderate to severe pain was experienced by 30.6% of the patients, a lower proportion compared to previous research. Pain experienced by cancer survivors was significantly lower compared to most treatment groups. Our results imply that both the prevalence of pain and pain severity declined in the past decade. Increased attention to the assessment and management of pain might have fostered the decline in the prevalence and severity of pain.

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Section: Discussionsupporting

confidence: 90%

Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis

Snijders

Brom

Theunissen

et al. 2023

Cancers

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“…All patients reviewed had metastatic, terminal cancer with substantial opioid dose escalations in the three months prior to procedure, re ecting uncontrolled pain despite multimodal pain regimens. This is not surprising given that inadequately controlled pain is unfortunately an ongoing issue for cancer patients at the end of life [10].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Cingulotomy for Refractory Malignant Cancer Pain: A Case Series

Fitzgerald

Sandhu

Tombazzi

et al. 2023

Preprint

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Purpose Poorly controlled pain is a significant quality of life issue for patients with advanced cancer. Patients often suffer from uncontrolled pain or intolerable side effects of treatment despite receiving multi-modal care with stepwise escalation of opioids. Interventional procedures impacting central pain pathways have demonstrated promise in treating pharmacologically intractable cancer pain and may be underutilized, especially in patients with escalating opioid use. The aim of this study was to assess effectiveness of bilateral anterior cingulotomy—a minimally invasive neurosurgical procedure—in patients with refractory malignant cancer pain through describing opioid use trends pre- and post-procedure and by comparing pain scores. Methods This is a retrospective review of a case series of six patients with refractory malignant pain who underwent bilateral anterior cingulotomy. Response to procedure was measured by percent change of pain scores and average daily opioid dose reduction. In addition, demographics, oncologic history, discharge disposition, survival time post-procedure, and complications were reported. Results Six unique patients underwent seven total procedures between 2019–2022. Average daily OME (oral morphine equivalent) dose 48 hours prior to procedure was 4411 mg. At discharge, average daily OME dose was 250 mg, an 89% dose reduction from 48 hours prior to procedure. Pain scores reduced by 43% during this same time period. Conclusion Cingulotomy effectively reduced pain scores with a concurrent reduction in opioid dosing in our cohort of patients with medically refractory malignant cancer pain. Further research is warranted to identify advanced cancer patients who may benefit most from this procedure and inform clinical adoption.

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“…Despite the significant progress made in cancer pain management and awareness, pain is undertreated in one-third of patients, affecting the quality of life (QoL) [ 18 ]. More than eight million people worldwide die each year of advanced cancer [ 19 ].…”

Section: Overview On Cancer Pain Management and Related Issuesmentioning

confidence: 99%

Practical Considerations for the Use of Cannabis in Cancer Pain Management—What a Medical Oncologist Should Know

Gorzo

Havași²,

Spînu³

et al. 2022

JCM

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Pain is a highly debilitating emotional and sensory experience that significantly affects quality of life (QoL). Numerous chronic conditions, including cancer, are associated with chronic pain. In the setting of malignancy, pain can be a consequence of the tumor itself or of life-saving interventions, including surgery, chemotherapy, and radiotherapy. Despite significant pharmacological advances and awareness campaigns, pain remains undertreated in one-third of patients. To date, opioids have been the mainstay of cancer pain management. The problematic side effects and unsatisfactory pain relief of opioids have revived patients’ and physicians’ interest in finding new solutions, including cannabis and cannabinoids. The medical use of cannabis has been prohibited for decades, and it remains in Schedule 1 of the Misuse of Drugs Regulations. Currently, the legal context for its usage has become more permissive. Various preclinical and observational studies have aimed to prove that cannabinoids could be effective in cancer pain management. However, their clinical utility must be further supported by high-quality clinical trials.

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Living systematic review to assess the analgesic undertreatment in cancer patients

Cited by 28 publications

References 73 publications

Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis

Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis

Efficacy of Cingulotomy for Refractory Malignant Cancer Pain: A Case Series

Practical Considerations for the Use of Cannabis in Cancer Pain Management—What a Medical Oncologist Should Know

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