Cancer-related neuropathic pain in out-patient oncology clinics: a European survey

Abstract

BackgroundAlthough pain is frequently experienced by patients with cancer, it remains under-treated. The primary aim of this study was to estimate the prevalence of cancer-related neuropathic pain (CRNP) in patients with chronic pain who attended an outpatient clinic for standard care in Europe (irrespective of the reason or stage of the cancer). The secondary aims of this study were to characterise pain and cancer in patients with CRNP (including treatment) and to evaluate the usefulness of the painDETECT (PD-Q) screening tool to help physicians identify a potential neuropathic component of cancer-related pain.MethodsAn observational, non-interventional, cross-sectional, multi-centre study of adult patients with cancer using patient and physician case report forms (CRFs). Patients with CRNP were identified by physicians’ clinical assessments after examining the completed PD-Q.ResultsA total of 951 patients visiting outpatient clinics across Europe were enrolled in this study between August 2010 and July 2011. Of these, 310 patients (32.60%; 95% confidence interval 29.62, 35.58) were identified as having CRNP. Twenty-nine of 39 (74.4%) physicians who completed the CRF relating to the PD-Q considered it a useful tool to help detect CRNP in daily practice and 28 of 39 (71.8%) indicated that they would use this tool in the future for most or some of their patients. Data from physicians before and after review of the completed PD-Qs showed a shift in clinical opinion (either to positive CRNP diagnosis [yes] or negative CRNP diagnosis [no]) in respect of 142 patients; about half of which (74) were categorised with an initial diagnosis of unknown. Opinions also shifted from a no to a yes diagnosis in 10 patients and from a yes to a no diagnosis in 51 patients.ConclusionsApproximately one-third of adults with cancer experiencing chronic pain attending outpatient clinics as part of routine care were considered to have CRNP in the opinion of the physicians after considering scores on the PD-Q. While physicians did not consider the PD-Q to be a useful tool for all patients, shifts in diagnosis before and after the use of this tool indicate that it may help physicians identify CRNP, especially where there is initial uncertainty.

Screening for Cancer-Related Neuropathic Pain in the Oncology Outpatient Setting in the United Kingdom

“…A non-interventional, cross-sectional study conducted in five European countries, including the UK, estimated that 32.6% of outpatients experiencing chronic pain experienced cancer-related neuropathic pain (CRNP) [18]. This is consistent with estimates from international studies conducted in a variety of inpatient and outpatient settings that up to 39% of patients with cancer may experience pain with a neuropathic component [14].…”

“…The authors would like to thank Sarah Wensley, Pfizer Ltd and all the UK investigators (full list reported elsewhere) [18] for their contribution to the study and Sarah Bowen for her role in the statistical analysis. The authors were not compensated for their work on the manuscript.…”

Prevalencia y etiopatogenia del dolor oncológico neuropático en el anciano

“…El único estudio publicado hasta la fecha en el que se aportan datos específicos sobre la prevalencia de DNO en población anciana (> 65 años) es el publicado por Garzón-Rodríguez et al 19 . Es un estudio observacional, multicéntrico europeo (Dinamarca, Alemania, Grecia, España y Reino Unido) realizado entre el 2010-2011 en pacientes oncológicos paliativos ambulantes.…”

Neuropathic cancer pain: What we are dealing with? How to manage it?

“…In a recent European survey, the proportion of chemotherapy-induced NP (CINP) pain among other NCP types was 32.6% 47. There are several reports showing that CP and NCP were diagnosed and treated inefficiently 20,22,48.…”