Undertreatment of pain with metastatic cancer

Abstract

The landmark paper discussed in this chapter is ‘Pain and its treatment in outpatients with metastatic cancer’, published by Cleeland et al. in 1994. Cleeland and colleagues provide one of the first epidemiological studies outlining the prevalence of cancer pain in outpatients with metastatic cancer. The study drew attention to the undertreatment of pain and identified predictors of poor pain management, such as discrepancies between patient and health professional judgements regarding the degree of pain-induced interference. Issues highlighted by Cleeland and colleagues persist, including high prevalence of pain reported in patients with metastatic cancer, a lack of clarity on good practice guidelines for assessing pain in patients with cancer, and substandard quality of palliative and end-of-life services by minority ethnic groups. Pain management in outpatients with cancer remains a complex issue, but innovative strategies are emerging to support the role of the health professional and encouraging self-management in patients.