The prevalence of pain in four cancers

Greenwald, Howard P.; Bonica, John J.; Bergner, Marilyn

doi:10.1002/1097-0142(19871115)60:10<2563::aid-cncr2820601036>3.0.co;2-l

Cited by 142 publications

(60 citation statements)

References 11 publications

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“…We found that three-fourths of patients suffer some degree of pain and in about one-third of cases this pain does significantly affect daily activities. These figures are consistent with a smaller series of patients with various stages of lung cancer (61 cases with localised disease, 91 with regional, 68 metastatic and 40 with undetermined extension), in which pain was assessed by a graphic rating scale combining visual, numerical and descriptive indicators: only 71 out of 256 patients (27.7%) stated they had had no pain in the last week, while 50.7% had suffered moderate to very bad pain (Greenwald et al, 1987). Overall, these data confirm that pain is an issue of great relevance in the clinical presentation of advanced NSCLC.…”

Section: Discussionsupporting

confidence: 86%

Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

Maïo¹,

Gridelli²,

Gallo³

et al. 2004

Br J Cancer

116

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Pain is a highly distressing symptom for patients with advanced cancer. WHO analgesic ladder is widely accepted as a guideline for its treatment. Our aim was to describe pain prevalence among patients diagnosed with advanced non-small-cell lung cancer (NSCLC), impact of pain on quality of life (QoL) and adequacy of pain management. Data of 1021 Italian patients enrolled in three randomised trials of chemotherapy for NSCLC were pooled. QoL was assessed by EORTC QLQ-C30 and LC-13. Analgesic consumption during the 3 weeks following QoL assessment was recorded. Adequacy of pain management was evaluated by the Pain Management Index (PMI). Some pain was reported by 74% of patients (42% mild, 24% moderate and 7% severe); 50% stated pain was affecting daily activities (30% a little, 16% quite a bit, 3% very much). Bone metastases strongly affected presence of pain. Mean global QoL linearly decreased from 64.9 to 36.4 from patients without pain to those with severe pain (Po0.001). According to PMI, 616 out of 752 patients reporting pain (82%) received inadequate analgesic treatment. Bone metastases were associated with improved adequacy and worst pain with reduced adequacy at multivariate analysis. In conclusion, pain is common in patients with advanced NSCLC, significantly affects QoL, and is frequently undertreated. We recommend that: (i) pain self-assessment should be part of oncological clinical practice; (ii) pain control should be a primary goal in clinical practice and in clinical trials; (iii) physicians should receive more training in pain management; (iv) analgesic treatment deserves greater attention in protocols of anticancer treatment.

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Section: Discussionsupporting

confidence: 86%

Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

Maïo¹,

Gridelli²,

Gallo³

et al. 2004

Br J Cancer

116

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“…Specifically, differences were observed between pain tolerance and ethnic groups. Therefore, data from this investigation support the observations of earlier studies in nonathletic populations that reported differences between Afro-American subjects, Caucasians, and varying other ethnic groups with respect to pain expression (2,3,4,6,11). However, the confirmation of these observations with the findings of the earlier studies on pain expression and ethnicity (4, 5, 6, 11) may be limited by the terminology, subject population, and subjective measures of pain.…”

Section: Discussionsupporting

confidence: 89%

“…The findings of this recent investigation support the previous observations (2,13,14) that cultures may be associated with specific ethnicity in the expression of pain. In addition, other studies have reported differences in pain expression among ethnic racial populations under varied conditions (4,6,11). The assumption that ethnicity and culture affect an individual's response to pain has been demonstrated with a variety of methods (4,5,11,13,14).…”

mentioning

confidence: 99%

Pain and Ethnicity in Athletes

Buxton¹,

Perrin²,

Hetzler³

et al. 1993

Journal of Sport Rehabilitation

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Abstract:The purpose of this investigation was to determine the relationship between ethnicity and acute pain response in male athletes. Subjects included 93 male athletes (age = 18.65 ± .58 years) of differing ethnicity. Each subject performed a Cold Pressor Test (CPT) and was evaluated for pain threshold and pain tolerance times. Two one-way analyses of variance were performed to analyze the data. The results indicated that significant differences existed in pain tolerance times between ethnic groups (p<.05). However, no differences were observed in pain threshold times. These findings support the existence of a difference in pain tolerance between ethnic groups in collegiate athletes. Article:Although pain is a physiological response, an individual's pain perception has been related to psychological, social, cultural, and ethnic factors (9). The sensation of pain and its secondary dysfunction are primary reasons athletes seek treatment from sports medicine practitioners. To date, little information about the relationship between pain response in collegiate athletes is available in the literature. This is noteworthy because athletes represent a unique group of individuals from varied cultural and ethnic backgrounds who suffer from a variety of injuries due to training and competition. Because the majority of these athletes are young and otherwise healthy, they may respond to acute pain differently than do the varied cultural and ethnic populations previously studied.

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Section: British Journal Of Cancermentioning

confidence: 99%

“…If this is implemented consistently and proper palliative approaches are maximised, it has been claimed that effective pain control may be achieved in 80% of cancer patients (Perron and Schonwetter, 2001). However, despite the widespread acceptance of this strategy, more than 40% of prostate cancer patients in routine practice settings report the presence of pain (Greenwald et al, 1987;Portenoy, 1989;Larue et al, 1995;Sandblom et al, 2001).Health-related quality of life in the final year of life in terminally ill patients, including men with prostate cancer, has been studied previously (Liao et al, 2000;Litwin et al, 2001;Melmed et al, 2002). However, in order to reach a full understanding of how healthrelated quality of life is affected by approaching death, all patients in a population-based sample must be studied.…”

mentioning

confidence: 99%

A population-based study of pain and quality of life during the year before death in men with prostate cancer

et al. 2004

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In order to explore how health-related quality of life changes towards the end of life, a questionnaire including the EuroQOl form and the Brief Pain Inventory form was sent to all men with prostate cancer in the county of Ö stergö tland, Sweden, in September 1999. Responders who had died prior to 1 January 2001 were later identified retrospectively. Of the 1442 men who received the questionnaire, 1243 responded (86.2%). In the group of responders, 167 had died within the study period, 66 of prostate cancer. In multivariate analysis, pain as well as death within the period of study were found to predict decreased quality of life significantly. Of those who died of prostate cancer, 29.0% had rated their worst pain the previous week as severe. The same figure for those still alive was 10.5%. On a visual analogue scale (range 0 -100), the mean rating of quality of life for those who subsequently died of prostate cancer was 54.0 (95% confidence interval 75.2) and those still alive was 70.0 (71.2). In conclusion, health-related quality of life gradually declines during the last year of life in men with prostate cancer. This decline may partly be avoided by an optimised pain management. (2004) In recent years, health-related quality of life has become one of the most important end points for studies on men with prostate cancer, especially men with cancer at an advanced stage. Caring for cancer patients in the last years of life requires a good understanding of how health-related quality of life can be improved when efforts to prolong life become increasingly futile. Adequate pain and symptom management, avoidance of inappropriate prolongation of the dying process, achievement of a sense of control, relief of burdens, and the strengthening of relations with loved ones have been found to be the most important domains from the patient's perspective of palliative treatment (Singer et al, 1999). Of all factors affecting health-related quality of life, however, pain is usually considered the most prominent factor for patients approaching death (Elliott, 1997). British Journal of CancerAlthough pain management is fundamental in terminal care (Steinhauser et al, 2000;Wrede-Seaman, 2001), it is often undertreated (Perron and Schonwetter, 2001). According to the World Health Organisation's guidelines for the stepwise management of pain in cancer, the potency of the analgesia provided, ranging from non-opioids and opioids for moderate pain (e.g. dextropropoxyphene, codeine and tramadol) to opioids for severe pain (e.g. morphine, cetobemidone and fentanyl), should be adjusted to the patient's experienced level of pain (WHO, 1986). If this is implemented consistently and proper palliative approaches are maximised, it has been claimed that effective pain control may be achieved in 80% of cancer patients (Perron and Schonwetter, 2001). However, despite the widespread acceptance of this strategy, more than 40% of prostate cancer patients in routine practice settings report the presence of pain (Greenwald et al, 1987;Portenoy, 1989;L...

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The prevalence of pain in four cancers

Cited by 142 publications

References 11 publications

Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

Prevalence and management of pain in Italian patients with advanced non-small-cell lung cancer

Pain and Ethnicity in Athletes

A population-based study of pain and quality of life during the year before death in men with prostate cancer

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