scholarly journals Cancer, cancer pain and the ‘Cancer Pain Initiative’

2021 ◽  
Vol 25 (2) ◽  
Author(s):  
Tariq Hayat Khan
Keyword(s):  
Intensive Care ◽  
Pain Management ◽  
Cancer Patient ◽  
Cancer Pain ◽  
Cancer Patients ◽  
National Level ◽  
Key Words Cancer ◽  
Pain Specialist ◽  
Pain Center ◽  
Pain Patients

The number of cancer patients has been steadily increasing and with it the number of cancer related pain patients is also increasing. Cancer pain (CP) is the most unique and versatile pain, regarding type, intensity, site, variations and the needed management modalities. No one pain specialist or the pain center can be capable of adequately manage every cancer patient. In this background, an idea to confront this menace at a national level with a combined effort is presented. If implemented it is hoped that the CP patients will get rid of at least the worry about their excruciating pain. The idea of the ‘Cancer Pain Initiative’ has been in circulation for quite some time, but needs to be discussed at various levels. Key words: Cancer; Cancer pain; Pain management Citation: Khan TH. Cancer, cancer pain and the ‘Cancer Pain Initiative’. Anaesth. pain intensive care 2021;25(2):126–12. DOI: 10.35975/apic.v25i2.1482

scholarly journals Infectious Complications Related to Intrathecal Drug Delivery System and Spinal Cord Stimulator System Implantations at a Comprehensive Cancer Pain Center

2013 ◽  
Vol 3;16 (3;5) ◽  
pp. 251-257 ◽  
Author(s):  
Mitchell P. Engle
Keyword(s):  
Drug Delivery ◽  
Spinal Cord ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Infectious Complication ◽  
Infectious Complications ◽  
Surgical Time ◽  
Intrathecal Drug Delivery ◽  
Pain Center ◽  
Pain Patients

Background: Intrathecal drug delivery (IDD) and spinal cord stimulator (SCS) systems are implantable devices for the management of both chronic and cancer pain. Although these therapies have favorable long-term outcomes, they are associated with occasional complications including infection. The incidence of infectious complications varies from 2 - 8% and frequently requires prolonged antibiotics and device revision or removal. Cancer patients are particularly susceptible to infectious complications because they are immunocompromised, malnourished, and receiving cytotoxic cancer-related therapies. Objective: Determine if cancer pain patients have a higher incidence of infectious complications following implantation of IDD or SCS systems than non-cancer pain patients. Study Design: Retrospective chart review. Setting: Single tertiary comprehensive cancer hospital. Methods: Following local Institutional Review Board (IRB) approval, we collected data on infectious complications for IDD and SCS systems implanted at MD Anderson Cancer Center for the treatment of cancer and chronic pain. The examined implants were performed from July 15, 2006, to July 14, 2009. In addition, we obtained data regarding patient comorbidities and perioperative risk factors to assess their impact on infectious complications. Results: One hundred forty-two devices were implanted in 131 patients during the examined period. Eighty-three of the devices were IDD systems and 59 were SCS systems. Eighty percent of the patients had a diagnosis of cancer. Four infectious complications were noted with an overall infectious risk of 2.8%. The infection rate was 2.4% for IDD systems versus 3.4% for SCS systems (P = 1). All infections were at the implantable pulse generator (IPG) or pump pocket site. The rate of infection was 2.7% for cancer patients and 3.3% for non-cancer patients (P = 1). Neither the perioperative administration of prophylactic antibiotics (P = 0.4) nor the National Nosocomial Infection Surveillance (NNIS) risk level for individual patients (P = 0.15) were statistically associated with infectious complication. The mean surgical time was longer for cases with infection at 215 ± 93 minutes versus 132 ± 52 minutes for those without infection which was statistically significant (P = 0.02). Limitations: The major limitation of this study is that it was a retrospective analysis. An additional limitation is that 51(38.9%) of our patients either died or were lost to follow-up during the year following implantation which may have led to an underestimation of our infection rates. Conclusions: The experience of this tertiary cancer pain center demonstrates that infectious complications following implantation of IDD and SCS systems are relatively rare events in cancer patients. Contrary to our initial hypothesis, no difference was found in the infection rate between cancer and non-cancer patients. The main factor associated with increased risk of infectious complications was increased surgical time, indicating a need to minimize patient time in the operating room. The low infectious complication rate seen in this series compared to previous reports in non-cancer patients is likely multifactorial in nature. Key Words: Spinal cord stimulation, intrathecal drug delivery, implantable pain therapies, neuromodulation, pain procedures, pain, complications, infection, surgical site infection

Pain Management in the Cancer Patient

1998 ◽  
Vol 11 (5) ◽  
pp. 349-373 ◽  
Author(s):  
Kristi L. Lenz ◽  
Eileen M. Marley
Keyword(s):  
Pain Management ◽  
Cancer Patient ◽  
Cancer Pain ◽  
Pain Control ◽  
Cancer Pain Management ◽  
Basic Principles ◽  
Adequate Pain Management

Of the over one million patients diagnosed with cancer each year, 30 percent will have pain at diagnosis and up to 85 percent will have pain as their disease progresses. Adequate pain management continues to be hindered by multiple patient-and clinician-related barriers; however, with increased awareness and knowledge, the pharmacy practitioner can play a key role in facilitating pain management. This review will focus on the mechanisms of cancer pain, the role of non-opioids, opioids, and adjuvant agents in the treatment of cancer pain, and the basic principles of cancer pain management that allow 70 to 90 percent of patients to achieve excellent pain control.

scholarly journals Cancer Pain Management and Pain Interference with Daily Functioning among Cancer Patients in Gondar University Hospital

2017 ◽  
Vol 2017 ◽  
pp. 1-12
Author(s):  
Henok Getachew Tegegn ◽  
Eyob Alemayehu Gebreyohannes
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Pain Treatment ◽  
Pain Interference ◽  
University Hospital ◽  
Public Health Burden ◽  
Pain Management Index ◽  
Experienced Pain ◽  
Pain Prevalence

Cancer is an increasing public health burden for Ethiopia. Pain is among the most common symptoms in patients with cancer. Hence, we aimed to assess cancer pain prevalence, cancer pain interference, and adequacy of cancer pain treatment in the oncology ward of an Ethiopian teaching hospital. Of 83 patients, total of 76 (91.6%) cancer patients experienced pain with varying degree of severity, and 7 (8.4%) patients experienced severe pain. Of the 76 cancer patients with pain, 68 (89.2%) experienced pain interference with their daily activities. Fifty-four (65%) patients were receiving inadequate cancer pain treatment with negative Pain Management Index. Therefore, it is vital to anticipate and assess pain of the cancer patients as routine clinical practice, to optimize analgesic therapy, and to identify and overcome barriers to adequate pain management.

Pain in children

2018 ◽  
Author(s):  
Julia Wager ◽  
Boris Zernikow
Keyword(s):  
Chronic Pain ◽  
Pain Management ◽  
Cancer Pain ◽  
Acute Pain ◽  
Pain Assessment ◽  
Education For All ◽  
Special Focus ◽  
Assessment And Treatment ◽  
Specialized Service ◽  
Pain Patients

Pain management in children is a specialized service. Pain aetiology, assessment, and treatment vary at every age from pre-term foetuses at 23 weeks gestation to adolescence. In this chapter of European Pain Management advances in our understanding of pain assessment are reviewed, particularly in the use of developmentally relevant technology. Advances in acute pain, cancer pain, and in chronic pain are also reviewed, with a special focus on innovations in multidisciplinary treatments for chronic pain. There is a need to raise awareness and understanding of the needs of paediatric pain patients, and their family members. Education for all professionals who interact with pain patients is essential, as is the need to invest in specialized pain management services, and professionals, across Europe.

Survival in Adult Italian Cancer Patients, 1978–1989

1997 ◽  
Vol 83 (1) ◽  
pp. 39-425 ◽  
Author(s):  
Arduino Verdecchia ◽  
Arduino Verdecchia ◽  
Riccardo Capocaccia ◽  
Roberta De Angelis ◽  
Fulvia Valente ◽  
...  
Keyword(s):  
Cancer Patient ◽  
Cancer Patients ◽  
Patient Survival ◽  
National Level ◽  
International Comparisons ◽  
Relative Survival ◽  
Cancer Registries ◽  
Population Based ◽  
Cancer Site ◽  
Malignant Neoplasms

Aims To present a systematic analysis of population-based cancer patient survival in Italy. Methods Population-based survival data have been made available from 10 Italian cancer registries within the ITACARE project. Data, collected and validated using a common protocol, included over 100,000 patients with cancer diagnosed between 1978 and 1989. Multivariate weighted analysis was used to provide relative survival estimates attributable to Italy at national level. Results Results are presented, according to a systematic frame, as the main object of the ITACARE study, involving crude and relative survival figures for adult Italian cancer patients, by age, sex, period of diagnosis and registry area. An estimate with reference to Italy as a whole is also presented by cancer site and for all malignant neoplasms combined. Age-standardized relative survival figures are presented to allow comparisons between Italian registries and also to give a basis for international comparisons with countries involved in the EUROCARE study. Conclusions For the fist time, population-based survival of cancer patients is made available in Italy on a large scale analysis of data from all the Italian cancer registries in a combined action. Estimates of cancer patient survival at a national level in Italy allow proper international comparisons with European countries and give elements of evaluation and discussion on the performance of the Italian health care system.

Pancreatic cancer survivorship: Intrathecal drug delivery system for pain management

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 14100-14100
Author(s):  
L. J. Stearns ◽  
W. H. Poling ◽  
J. Kiser ◽  
J. Nasternak ◽  
E. Berryman
Keyword(s):  
Drug Delivery ◽  
Pancreatic Cancer ◽  
Pain Management ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Treatment Center ◽  
Celiac Plexus Block ◽  
Maricopa County ◽  
Intrathecal Drug Delivery ◽  
The Mean

14100 Background: Pancreatic cancer is predominantly unresectable at diagnosis and is most frequently fatal. Nationally the average survivorship is 10 months. Among pancreatic cancer patients, pain is associated with decreased survival rates. Quality of life and survivorship are the principal outcome measures for these patients. Successful pain management may be a significant predictor of prolonged survivorship. No study has demonstrated an impact on survivorship secondary to the treatment of pancreatic cancer pain and the use of Intrathecal Drug Delivery Systems (IDDS). Methods: A retrospective chart review identified all pancreatic cancer patients treated at a cancer pain treatment center between January 2002 and June 2005. 43 patients had known dates of diagnosis and known dates of death. The Arizona Department of Health Services Cancer Registry provided similar information for pancreatic cancer patients residing in Maricopa County for that time period. 713 Maricopa county residents had known dates of diagnosis and known dates of death. Results: Among the Maricopa County pancreatic cancer patients, the mean survivorship was 5 months. Among the treatement center patients who did not receive the IDDS for pain, 10 (23.3%), the mean survivorship was 10.8 months. Among the pancreatic cancer patients receiving IDDS for pain management, 33 (76.7%), the mean survivorship was 14.2 months. Mean survivorship among the treatment center patients receiving IDDS for pain management is nearly 3 times greater than the general survivorship of pancreatic cancer patients in Maricopa County. Among the treatement center patients the mean survivorship is nearly 50% greater for patients receiving IDDS versus those that did not. Conclusions: The implantable IDDS for pain management among pancreatic cancer patients may be a significant predictor of increased survivorship. A larger sample size may be needed to detect significant differences in survivorship. Controlled studies examining survivorship as the primary outcome for patients with unresectable pancreatic cancer by evaluating the implantable IDDS as compared to usual care modalities such as comprehensive medical management (CMM) or neurolytic celiac plexus block (NCPB) for pain management are warranted. No significant financial relationships to disclose.

Differences in pain, symptom burden, and opioid use among cancer pain patients with active versus non-active disease.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20568-e20568
Author(s):  
Karina J Bouffard ◽  
Lakshmi Koyyalagunta ◽  
Salahardin Abdi ◽  
Mike Hernandez ◽  
Diane M. Novy
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Symptom Burden ◽  
Disease Status ◽  
Pain Medication ◽  
Categorical Variables ◽  
Opioid Use ◽  
Poor Appetite ◽  
Pain Patients ◽  
Active Disease

e20568 Background: Many cancer survivors with non-active disease suffer with pain and other symptoms. This study investigated differences in symptoms and opioid use among cancer pain patients with active versus non-active disease. Methods: Data were obtained from 518 consecutive new patients seen at the Pain Management Center of MD Anderson Cancer Center from 01/01/09 to 06/30/09. Measures: Usual pain was rated on the Brief Pain Inventory. The Edmonton Symptom Assessment Scale (ESAS) was used for ratings of fatigue, shortness of breath, poor appetite, depression, anxiety, drowsiness, difficulty thinking clearly and insomnia. Opioid use was calculated in morphine equivalency daily dose (MEDD) milligrams based on the sum of long- and short-acting opioids used per day. Analyses of Data: Independent samples t-tests were used to make comparisons between patients with active versus non-active disease on continuous variables. Chi-square tests were used to make comparisons across disease status on categorical variables. Results: 349 patients had active disease; 169 patients had non-active disease. Patients with active disease received significantly higher MEDD (125.6 ± 158.8 mg) versus patients with non-active disease (74.4 ± 87.0 mg). Patients with active disease reported significantly higher mean scores on fatigue, poor appetite, and drowsiness. Average weekly pain scores were comparable and moderately high for both groups of patients. Other symptoms and clinical characteristics were not significantly different across disease status. Conclusions: Plausible explanations for the higher opioid use and symptom burden among patients with active disease are cancer treatments and disease progression. A higher level of pain medication is often needed to achieve pain management during active treatment or following recent surgery. The finding of higher fatigue, poor appetite, and drowsiness among those with active disease is also consistent with the symptom burden expected from treatment. Although patients with active disease have a greater symptom burden and need for pain medication, there is a need for pain and symptom management among patients in the non-active disease phase of survivorship.

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