Exploring the Patients' Perception of Background and Breakthrough Pain: A McGill Pain Questionnaire Inquiry in Patients with Bone Cancer Pain

Hansen, Rie Bager; Frost, Charlotte Ørsted; Sonne, N. M.; Johnsen, Anna Thit; Heegaard, Anne‐Marie

doi:10.1089/jpm.2018.0621

Cited by 6 publications

(10 citation statements)

References 4 publications

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“…Bone is the preferred metastatic site for prevalent cancers, such as breast and prostate cancer [ 33 ] and metastatic bone disease can be very painful and difficult to treat with the available analgesics [ 9 ]. While increasing efforts are being made to identify new analgesics for the treatment of chronic pain conditions, most promising targets lack translational value and fail in the early stages of clinical trials, suggesting that a better characterization of the animal models is needed [ 12 , 13 ]. In models of painful bone metastases, a recurrent debate is whether spinal microglia are involved in the transmission of CIBP, with contradictory data being reported [ 20 , 26 , 30 , 31 , 32 , 34 , 35 , 36 ].…”

Section: Discussionmentioning

confidence: 99%

“…CIBP is particularly difficult to relieve with the available analgesic therapies [ 9 , 10 ], and there is an apparent need for novel therapeutic approaches to handle both background and breakthrough pain. Drug development is guided by the promise of targets, but, as many analgesic drug trials fail [ 11 ], it may be time to reconsider whether the models developed for CIBP are exploited in the best possible way when translating the results into the clinic [ 12 , 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

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Modulation of Rat Cancer-Induced Bone Pain is Independent of Spinal Microglia Activity

Diaz‐delCastillo

Hansen

Appel

et al. 2020

Cancers

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The dissemination of cancer to bone can cause significant cancer-induced bone pain (CIBP), severely impairing the patient’s quality of life. Several rodent models have been developed to explore the nociceptive mechanisms of CIBP, including intratibial inoculation of breast carcinoma cells in syngeneic Sprague Dawley rats. Using this model, we investigated whether resident spinal microglial cells are involved in the transmission and modulation of CIBP, a long-debated disease feature. Immunohistochemical staining of ionizing calcium-binding adaptor molecule 1 (Iba-1) and phosphorylated p38-mitogen-activated protein kinase (P-p38 MAPK) showed no spinal microglial reaction in cancer-bearing rats, independently of disease stage, sex, or carcinoma cell line. As a positive control, significant upregulation of both Iba-1 and P-p38 was observed in a rat model of neuropathic pain. Additionally, intrathecal administration of the microglial inhibitor minocycline did not ameliorate pain-like behaviors in cancer-bearing rats, in contrast to spinal morphine administration. Our results indicate that microglial reaction is not a main player in CIBP, adding to the debate that even within the same models of CIBP, significant variations are seen in disease features considered potential drug targets. We suggest that this heterogeneity may reflect the clinical landscape, underscoring the need for understanding the translational value of CIBP models.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Modulation of Rat Cancer-Induced Bone Pain is Independent of Spinal Microglia Activity

Diaz‐delCastillo

Hansen

Appel

et al. 2020

Cancers

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“…The patient-reported pain site provides important diagnostic information, and the classic perception that BTCP often occurs at the same location as the background pain, and represents a brief flare-up of the background pain, is also confirmed in recent research (19,20). Additionally, data from a pilot study suggest that patients use qualitatively similar pain descriptors for background pain and BTCP (21).…”

Section: Assessment Including the Patient Perspectivementioning

confidence: 63%

Breakthrough cancer pain in 2020

Løhre

Thronæs

Klepstad

2020

Current Opinion in Supportive &Amp; Palliative Care

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Purpose of the review: An overview on breakthrough cancer pain (BTCP), including inherent limitations of the terminology, assessment, clinical presentation, and treatment options.Recent findings: The estimated prevalence of BTCP is dependent on the defined cutoffs for controlled background pain and the magnitude of the pain flare. In addition, pain flares outside the definition of BTCP are prevalent. In the 11th Revision of the International Classification of Diseases (ICD-11), the temporal characteristics of cancer pain are described as continuous background pain and intermittent episodic pain. BTCP should be assessed by validated methods, and the patient perspective should be included. The pain may be related to neoplastic destruction of bone, viscera, or nerve tissue and is characterized by rapid onset, high intensity, and short duration. Treatment directed towards painful metastases must be considered. Due to pharmacological properties mirroring the pain characteristics, transmucosal fentanyl formulations are important for the treatment of BTCP. Oral immediate release opioids can be used for slow-onset or predictable BTCP. For more difficult pain conditions, parenteral, or even intrathecal pain medication, may be indicated.Summary: All clinically relevant episodic pains must be adequately treated in accordance with the patient's preferences. Transmucosal fentanyl formulations are effective for BTCP.

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“…questionnaire (MPQ) is a very common scale that measures and evaluates various pain[27][28]. The MPQ contains 4 groups of 20 pain descriptions.…”

mentioning

confidence: 99%

Effectiveness of Tuina manipulation in patients with knee osteoarthritis: study protocol for a randomized controlled trial

Zhu

Guo

et al. 2020

Preprint

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Background: Knee osteoarthritis (KOA) is a common musculoskeletal disorder. Previous studies reported that Tuina manipulation showed benificial effects in management of musculoskeletal disorders . However, there was no enough evidence to support the effectiveness of Tuina manipulation for KOA. The purpose of this study is to evaluate the effectiveness of Tuina manipulation on pain and dysfunction of patients with KOA compared with health care education.Methods/Design: This study is a single-centre, two-arm, open-label randomized controlled trial (RCT). A total of 170 eligible KOA patients will be randomly assigned to the Tuina manipulation group or the health care education group in a 1:1 ratio. In the Tuina manipulation group, patients will receive a 30 min treatment including pain point assessment and manual therapy. The health care education group will receive 45 min of lecture and discussion. All treatments will be conducted three times a week for four weeks. The primary outcome is the Knee Injury and Osteoarthritis Outcome Score (KOOS). Secondary outcomes include the McGill Pain Questionnaire (MPQ) and 36-item Short-Form Health Survey (SF-36). The results will show the evidence of the effect of Tuina manipulation for KOA compared with health care education.Discussion: The design and methodology of the trial is rigorous and allows the collection of valuable data to assess the effect of a specific Tuina regimen for the treatment of KOA. Therefore, the trial will provide a solid foundation for future clinical research on KOA and Tuina therapy.Trial registration: This trial was registered with the Chinese Clinical Trial Registry on 24 February 2020 (ChiCTR2000030154), http://www.chictr.org.cn/index.aspx

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Exploring the Patients' Perception of Background and Breakthrough Pain: A McGill Pain Questionnaire Inquiry in Patients with Bone Cancer Pain

Cited by 6 publications

References 4 publications

Modulation of Rat Cancer-Induced Bone Pain is Independent of Spinal Microglia Activity

Modulation of Rat Cancer-Induced Bone Pain is Independent of Spinal Microglia Activity

Breakthrough cancer pain in 2020

Effectiveness of Tuina manipulation in patients with knee osteoarthritis: study protocol for a randomized controlled trial

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