The Patient with Difficult Cancer Pain

Mercadante, Sebastiano

doi:10.3390/cancers11040565

Cited by 24 publications

(16 citation statements)

References 50 publications

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“…Comparative data regarding BTcP in patients with lung cancer are limited. In a pioneer study performed in home care patients with lung cancer, somatic incident pain, which is a subtype of BTcP principally attributable to bone metastases, resulted to be a negative prognostic factor for pain control [6], as it occurred in the general cancer population [17][18][19]. In a retrospective study of 152 lung cancer patients, high pain intensity was associated with more BTcP episodes.…”

Section: Discussionmentioning

confidence: 99%

Breakthrough Pain in Patients with Lung Cancer. A Secondary Analysis of IOPS MS Study

Mercadante

Masedu

Valenti

et al. 2020

JCM

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Aim: To characterize breakthrough cancer pain (BTcP) in patients with lung cancer. Methods: This was a secondary analysis of multicenter study of patients with BTcP. Background pain intensity and opioid dose were recorded. The number of BTcP episodes, their intensity, predictability, onset, duration and interference with daily activities were collected. Opioids used for BTcP, the mean time to meaningful pain relief after taking medication, satisfaction and adverse effects were assessed. Results: 1087 patients with lung cancer were examined. In comparison with other tumors, patients with lung cancer showed: higher background pain intensity (p = 0.006), lower opioid doses (p = 0.005), higher intensity of BTcP (p = 0.005), movement (79.5%) and cough (8.2%), as principal triggers for predictable BTcP (p < 0.009), larger BTcP interference with daily activity (p = 0.0001), higher use of adjuvants (p = 0.0001). No relevant differences in the other parameters examined were found. Conclusion: Patients with lung cancer have their own peculiarities, including higher basal and BTcP pain intensity and the use of more adjuvant drugs for background pain. The most frequent triggers for predictable BTcP are movement and cough. Future studies should be performed to analyze the prevalence of BTcP in patients with different lung cancers as well as the optimal management strategy for background pain and BTcP.

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Section: Discussionmentioning

confidence: 99%

Breakthrough Pain in Patients with Lung Cancer. A Secondary Analysis of IOPS MS Study

Mercadante

Masedu

Valenti

et al. 2020

JCM

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“…This type of predictable event represents a subset of a large phenomenon commonly called breakthrough cancer pain (BTcP) [61]. BTcP is, by definition, a transitory increase in pain to greater than moderate intensity which occurs on top of a stable background pain, otherwise well-controlled with stable opioid doses given around the clock [62]. While an increase in dose of the selected opioid used for background pain may provide more analgesia allowing more chance of movement and fewer BTcP episodes induced by movement, this may result in the development of adverse effects.…”

Section: Management Of Breakthrough Cancer Painmentioning

confidence: 99%

Pain Management in Patients with Multiple Myeloma: An Update

Coluzzi

Rolke

Mercadante

2019

Cancers

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Most patients with multiple myeloma (MM) suffer from chronic pain at every stage of the natural disease process. This review focuses on the most common causes of chronic pain in MM patients: (1) pain from myeloma bone disease (MBD); (2) chemotherapy-induced peripheral neuropathy as a possible consequence of proteasome inhibitor therapy (i.e., bortezomib-induced); (3) post-herpetic neuralgia as a possible complication of varicella zoster virus reactivation because of post-transplantation immunodepression; and (4) pain in cancer survivors, with increasing numbers due to the success of antiblastic treatments, which have significantly improved overall survival and quality of life. In this review, non-pain specialists will find an overview including a detailed description of physiopathological mechanisms underlying central sensitization and pain chronification in bone pain, the rationale for the correct use of analgesics and invasive techniques in different pain syndromes, and the most recent recommendations published on these topics. The ultimate target of this review was to underlie that different types of pain can be observed in MM patients, and highlight that only after an accurate pain assessment, clinical examination, and pain classification, can pain be safely and effectively addressed by selecting the right analgesic option for the right patient.

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“…A recent editorial choice recently provided an update by experts in the field to offer an overview of cancer pain management in some critical different aspects, also preparing a special and successful issue from different authors entitled “Cancer Pains” [1,2,3,4]. This decision is worthy, as it addresses common problems encountered by oncologists in their daily practice, for which an expert advice may be required.…”

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confidence: 99%

Reviewing without a Clinical Background Is Detrimental for Cancer Pain Management

Mercadante¹

2019

Cancers

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Reviews are a fundamental space for summarizing and spreading knowledge on a particular topic. Methodologic skills may improve the clarity and the meaning of data presentation. A recent editorial choice provided an advanced update on a topic such as cancer pain, providing meaningful and appropriate information on hot topics of cancer pain management. Recent reviews have reported strange and misleading data, suggesting to some adjuvant drugs or opioids for mild-moderate pain instead of opioids on the basis of an incomprehensible analysis performed without any clinical sense. This is a serious problem because such information, published in an authoritative journal, could dis-educate oncologists in their daily practice.

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The Patient with Difficult Cancer Pain

Cited by 24 publications

References 50 publications

Breakthrough Pain in Patients with Lung Cancer. A Secondary Analysis of IOPS MS Study

Breakthrough Pain in Patients with Lung Cancer. A Secondary Analysis of IOPS MS Study

Pain Management in Patients with Multiple Myeloma: An Update

Reviewing without a Clinical Background Is Detrimental for Cancer Pain Management

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