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Cancers
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Cancer-Related Pain
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Cancer-Related Pain

A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: closed (31 August 2023) | Viewed by 17435

Special Issue Editors

Dr. Wendy H. Oldenmenger

E-Mail Website
Guest Editor
Department of Medical Oncology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
Interests: cancer pain; supportive care; self-management; patient-reported outcome measures; e-Health; person-centered care; symptom management
Dr. Evelien J.M. Kuip

E-Mail Website
Guest Editor
Department of Medical Oncology and Department of Anaesthesiology, Pain and Palliative Care, Radboud Medical Center, Nijmegen, The Netherlands
Interests: cancer pain; symptom management; supportive care; advanced care planning; shared decision making

Special Issue Information

Dear Colleagues, 

Pain is one of the most frequent and feared symptoms in people with cancer. Pain can interfere with all aspects of daily life, and adequately treated pain improves quality of life. Although the prevalence of cancer-related pain has remained stable over the years, knowledge of pain treatment has improved. There are various reasons why patients’ pain is not always adequately managed. First, complex pain problems: A substantial number of cancer patients have complex pain problems. For these patients we need new approaches and more in-depth knowledge of the underlying factors related to the beneficial and detrimental effects of specific opioids. Secondly, lack of support: Healthcare professionals do not always have enough knowledge or time to support patients with cancer-related pain. The Internet in particular provides us with new opportunities to closely monitor patients with cancer-related pain while they are at home. Lastly, misconceptions: patients have various misconceptions about pain and pain treatment that can contribute to inadequate pain management.

For this Special Issue, we welcome original and review papers that deal with the challenges in cancer-related pain. Contributions may range from observational studies to intervention studies to systematic reviews. We are especially looking for papers that provide insights into new and original research methodologies, original treatment approaches, improved monitoring and support, and organization of care.

Dr. Wendy H. Oldenmenger
Dr. Evelien J.M. Kuip
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cancer pain
  • supportive care
  • PROM
  • monitoring

Published Papers (6 papers)

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12 pages, 445 KiB  
Article
Assessing Nurses’ Knowledge and Attitudes towards Cancer Pain Management in Oman
by Adhari Al Zaabi, Maeen Al-Saadi, Husain Alaswami and Atika Al-Musalami
Cancers 2023, 15(15), 3925; https://doi.org/10.3390/cancers15153925 - 2 Aug 2023
Viewed by 1588
Abstract
Cancer care in the Gulf Cooperation Countries, including Oman, faces challenges due to increasing incidence and late-stage diagnoses. Cancer patients at later stages suffer complex symptoms, pain being a prominent one. Access to adequate pain relief is a global problem, including in the [...] Read more.
Cancer care in the Gulf Cooperation Countries, including Oman, faces challenges due to increasing incidence and late-stage diagnoses. Cancer patients at later stages suffer complex symptoms, pain being a prominent one. Access to adequate pain relief is a global problem, including in the Middle East, where palliative care is lacking. Nurses play a crucial role in pain assessment and management but often lack the necessary training, resulting in inadequate relief and prolonged hospital stays. This study aims to examine the knowledge and attitudes of nurses in a national cancer center toward the management of cancer pain, with the goal of identifying any gaps in their knowledge. This is a cross-sectional descriptive study conducted among nurses at the national cancer center in the Royal Hospital. The Nurses’ Knowledge and Attitudes Survey Regarding Pain (NKASRP) was used to determine the pain-related knowledge and attitudes of the nurses. Out of 150 registered nurses, 118 participated in this study (78% response rate). The mean NKASRP score was 49.6%. Half of the participants (50%) had a poor level of knowledge and attitude, 46% had fair knowledge and attitude, and only five participants (4%) had a good level of knowledge and attitude. A statistically significant association existed between knowledge and education level, years of experience caring for cancer patients, and prior pain management training (p < 0.05). A low level of knowledge and attitude among nurses in cancer pain management is a significant challenge in providing comprehensive cancer care. Adequate training of nurses in cancer pain management is essential to providing effective pain management and improving the quality of life of cancer patients. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
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13 pages, 259 KiB  
Article
Adherence to Opioid Patient Prescriber Agreements at a Safety Net Hospital
by Soraira Pacheco, Linh M. T. Nguyen, John M. Halphen, Nikitha N. Samy, Nathaniel R. Wilson, Gregory Sattler, Shane E. Wing, Christine Feng, Rex A. D. Paulino, Pulin Shah, Supriyanka Addimulam, Riddhi Patel, Curtis J. Wray, Joseph A. Arthur and David Hui
Cancers 2023, 15(11), 2943; https://doi.org/10.3390/cancers15112943 - 27 May 2023
Viewed by 1464
Abstract
Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and [...] Read more.
Patient prescriber agreements, also known as opioid contracts or opioid treatment agreements, have been recommended as a strategy for mitigating non-medical opioid use (NMOU). The purpose of our study was to characterize the proportion of patients with PPAs, the rate of non-adherence, and clinical predictors for PPA completion and non-adherence. This retrospective study covered consecutive cancer patients seen at a palliative care clinic at a safety net hospital between 1 September 2015 and 31 December 2019. We included patients 18 years or older with cancer diagnoses who received opioids. We collected patient characteristics at consultation and information regarding PPA. The primary purpose was to determine the frequency and predictors of patients with a PPA and non-adherence to PPAs. Descriptive statistics and multivariable logistic regression models were used for the analysis. The survey covered 905 patients having a mean age of 55 (range 18–93), of whom 474 (52%) were female, 423 (47%) were Hispanic, 603 (67%) were single, and 814 (90%) had advanced cancer. Of patients surveyed, 484 (54%) had a PPA, and 50 (10%) of these did not adhere to their PPA. In multivariable analysis, PPAs were associated with younger age (odds ratio [OR] 1.44; p = 0.02) and alcohol use (OR 1.72; p = 0.01). Non-adherence was associated with males (OR 3.66; p = 0.007), being single (OR 12.23; p = 0.003), tobacco (OR 3.34; p = 0.03) and alcohol use (OR 0.29; p = 0.02), contact with persons involved in criminal activity (OR 9.87; p < 0.001), use for non-malignant pain (OR 7.45; p = 0.006), and higher pain score (OR 1.2; p = 0.01). In summary, we found that PPA non-adherence occurred in a substantial minority of patients and was more likely in patients with known NMOU risk factors. These findings underscore the potential role of universal PPAs and systematic screening of NMOU risk factors to streamline care. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
14 pages, 1400 KiB  
Article
Adequacy of Pain Treatment in Radiotherapy Departments: Results of a Multicenter Study on 2104 Patients (Arise)
by Costanza M. Donati, Elena Nardi, Alice Zamagni, Giambattista Siepe, Filippo Mammini, Francesco Cellini, Alessia Di Rito, Maurizio Portaluri, Cristina De Tommaso, Anna Santacaterina, Consuelo Tamburella, Rossella Di Franco, Salvatore Parisi, Sabrina Cossa, Vincenzo Fusco, Antonella Bianculli, Pierpaolo Ziccarelli, Luigi Ziccarelli, Domenico Genovesi, Luciana Caravatta, Francesco Deodato, Gabriella Macchia, Francesco Fiorica, Giuseppe Napoli, Milly Buwenge, Romina Rossi, Marco Maltoni and Alessio G. Morgantiadd Show full author list remove Hide full author list
Cancers 2022, 14(19), 4660; https://doi.org/10.3390/cancers14194660 - 25 Sep 2022
Cited by 5 | Viewed by 1606
Abstract
Aim: The frequent inadequacy of pain management in cancer patients is well known. Moreover, the quality of analgesic treatment in patients treated with radiotherapy (RT) has only been rarely assessed. In order to study the latter topic, we conducted a multicenter, observational and [...] Read more.
Aim: The frequent inadequacy of pain management in cancer patients is well known. Moreover, the quality of analgesic treatment in patients treated with radiotherapy (RT) has only been rarely assessed. In order to study the latter topic, we conducted a multicenter, observational and prospective study based on the Pain Management Index (PMI) in RT Italian departments. Methods: We collected data on age, gender, tumor site and stage, performance status, treatment aim, and pain (type: CP—cancer pain, NCP—non-cancer pain, MP—mixed pain; intensity: NRS: Numeric Rating Scale). Furthermore, we analyzed the impact on PMI on these parameters, and we defined a pain score with values from 0 (NRS: 0, no pain) to 3 (NRS: 7–10: intense pain) and an analgesic score from 0 (pain medication not taken) to 3 (strong opioids). By subtracting the pain score from the analgesic score, we obtained the PMI value, considering cases with values < 0 as inadequate analgesic prescriptions. The Ethics Committees of the participating centers approved the study (ARISE-1 study). Results: Two thousand one hundred four non-selected outpatients with cancer and aged 18 years or older were enrolled in 13 RT departments. RT had curative and palliative intent in 62.4% and 37.6% patients, respectively. Tumor stage was non-metastatic in 57.3% and metastatic in 42.7% of subjects, respectively. Pain affected 1417 patients (CP: 49.5%, NCP: 32.0%; MP: 18.5%). PMI was < 0 in 45.0% of patients with pain. At multivariable analysis, inadequate pain management was significantly correlated with curative RT aim, ECOG performance status = 1 (versus both ECOG-PS3 and ECOG- PS4), breast cancer, non-cancer pain, and Central and South Italy RT Departments (versus Northern Italy).Conclusions: Pain management was less adequate in patients with more favorable clinical condition and stage. Educational and organizational strategies are needed in RT departments to reduce the non-negligible percentage of patients with inadequate analgesic therapy. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
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13 pages, 1088 KiB  
Article
Comparative Efficacy of Tapentadol versus Tapentadol Plus Duloxetine in Patients with Chemotherapy-Induced Peripheral Neuropathy (CIPN): A Randomized Non-Inferiority Clinical Trial
by Pasquale Sansone, Luca Gregorio Giaccari, Caterina Aurilio, Francesco Coppolino, Maria Beatrice Passavanti, Vincenzo Pota and Maria Caterina Pace
Cancers 2022, 14(16), 4002; https://doi.org/10.3390/cancers14164002 - 18 Aug 2022
Cited by 2 | Viewed by 1762
Abstract
Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication due to treatment with many commonly used anti-cancer agents. CIPN is a mainly sensory neuropathy that can be characterized by the appearance of motor and autonomic alterations. Clinicians may offer duloxetine (DLX) for patients [...] Read more.
Introduction: Chemotherapy-induced peripheral neuropathy (CIPN) is a common complication due to treatment with many commonly used anti-cancer agents. CIPN is a mainly sensory neuropathy that can be characterized by the appearance of motor and autonomic alterations. Clinicians may offer duloxetine (DLX) for patients with cancer experiencing CIPN. Our aim was to assess the non-inferiority of the analgesic effect and safety of tapentadol (TP) alone compared to duloxetine plus tapentadol administered to patients with CIPN. Methods: A total of 114 patients were enrolled in the study and randomized to receive tapentadol in a dosage of 50 to 500 mg/day (n = 56) or tapentadol plus duloxetine in a dosage of 60 to 120 mg/day (n = 58) for a period of 4 weeks. We evaluated the analgesia efficacy, defined as a decrease in pain on the NRS between the first administration and 28 days later. Secondary endpoints included analgesia efficacy at 28 and 42 days, defined by a decrease in DN4 and LEPs, decrease in quality of life, and the incidence of any serious or non-serious adverse events after the first administration. Results: In this randomized, double-blind trial comparing TP and TP plus DLX for CIPN management, TP was feasible and non-inferior to the association with DLX as far as the reduction of pain after chemotherapy at 28 days is concerned. Scores on other rating scales evaluating the quality of life, anxiety and depression, and the characteristics of pain revealed similar improvements associated with tapentadol versus duloxetine at these time points. Conclusion: The use of TP is a safe and effective analgesic therapy in patients with CIPN. Positive effects of TP were noted on the patients’ quality-of-life assessments. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
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13 pages, 500 KiB  
Article
Comparison of Side Effects of Nalbuphine and Morphine in the Treatment of Pain in children with Cancer: A Prospective Study
by Anna Kubica-Cielińska, Michał Czapla, Raúl Juárez-Vela, Clara Isabel Tejada-Garrido and Marzena Zielińska
Cancers 2022, 14(15), 3617; https://doi.org/10.3390/cancers14153617 - 25 Jul 2022
Cited by 3 | Viewed by 2264
Abstract
Contemporary pain management regimens in children do not include the use of the middle step of the analgesic ladder, i.e., weak opioids. The aim of this study was to analyse the comparison of side effects and the therapeutic efficacy of morphine and nalbuphine [...] Read more.
Contemporary pain management regimens in children do not include the use of the middle step of the analgesic ladder, i.e., weak opioids. The aim of this study was to analyse the comparison of side effects and the therapeutic efficacy of morphine and nalbuphine in pain management in children with cancer. We conducted an observational, prospective study and analysed medical records of patients treated at the Clinic of Paediatric Haematology and Oncology of the University Hospital in Wroclaw (Poland), who developed mucositis during treatment. The efficacy and safety of both drugs were analysed, and the efficacy of pain relief and the incidence of adverse effects characteristic of opioid drugs were compared. The cases of 96 of children treated with opioid drugs nalbuphine or morphine were analysed. Nalbuphine therapy was accompanied by a statistically significantly lower incidence of side effects such as skin pruritus, constipation, and micturition disorders compared to morphine (p < 0.05). After the discontinuation of nalbuphine, signs of withdrawal syndrome were much less frequent than after morphine (p < 0.05). In Conclusion, nalbuphine used as a pain killer in children with oncological disorder is a safe drug. It provides stable analgesia in most children. Compared to morphine, the side effects typical of opioid use are less common, and the incidence decreases over time. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
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39 pages, 787 KiB  
Systematic Review
Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis
by Rolf A. H. Snijders, Linda Brom, Maurice Theunissen and Marieke H. J. van den Beuken-van Everdingen
Cancers 2023, 15(3), 591; https://doi.org/10.3390/cancers15030591 - 18 Jan 2023
Cited by 54 | Viewed by 8131
Abstract
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 [...] Read more.
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. Full article
(This article belongs to the Special Issue Cancer-Related Pain)
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