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Maltoni MC, Donati CM, Rossi R, Morganti AG. Timely Palliative Care Could Be Another Benefit for Cancer Patients with Non-Malignant Pain. Cancers (Basel) 2023; 15:cancers15092588. [PMID: 37174054 PMCID: PMC10177181 DOI: 10.3390/cancers15092588] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
Cancer patients, as well as individuals in the general population, suffer from non-malignant pain (NMP), although with variable prevalence in the few studies dealing with this topic [...].
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Affiliation(s)
- Marco C Maltoni
- Oncology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Medical Oncology Unit, Department of Specialized, Experimental and Diagnostic Medicine (DIMES), Alma Mater Studiorum-University of Bologna, 40126 Bologna, Italy
| | - Costanza M Donati
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Radiation Oncology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
| | - Romina Rossi
- IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) "Dino Amadori", 47014 Meldola, Italy
| | - Alessio G Morganti
- Radiation Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
- Radiation Oncology, Department of Medical and Surgical Sciences (DIMEC), Alma Mater Studiorum-University of Bologna, Via Albertoni 15, 40138 Bologna, Italy
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Hui D, Abdelghani E, Chen J, Dibaj S, Zhukovsky D, Dev R, Tanco K, Haider A, Azhar A, Reddy A, Epner D, Arthur J, Dalal S, Heung Y, Reddy S, De La Cruz M, Liu D, Bruera E. Chronic Non-Malignant Pain in Patients with Cancer Seen at a Timely Outpatient Palliative Care Clinic. Cancers (Basel) 2020; 12:cancers12010214. [PMID: 31952220 PMCID: PMC7016539 DOI: 10.3390/cancers12010214] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Revised: 01/08/2020] [Accepted: 01/09/2020] [Indexed: 12/16/2022] Open
Abstract
Palliative care is seeing cancer patients earlier in the disease trajectory with a multitude of chronic issues. Chronic non-malignant pain (CNMP) in cancer patients is under-studied. In this prospective study, we examined the prevalence and management of CNMP in cancer patients seen at our supportive care clinic for consultation. We systematically characterized each pain type with the Brief Pain Inventory (BPI) and documented current treatments. The attending physician made the pain diagnoses according to the International Association for the Study of Pain (IASP) task force classification. Among 200 patients (mean age 60 years, 69% metastatic disease, 1-year survival of 77%), the median number of pain diagnosis was 2 (IQR 1–2); 67 (34%, 95% CI 28–41%) had a diagnosis of CNMP; 133 (67%) had cancer-related pain; and 52 (26%) had treatment-related pain. In total, 12/31 (39%) patients with only CNMP and 21/36 (58%) patients with CNMP and other pain diagnoses were on opioids. There was a total of 94 CNMP diagnoses among 67 patients, including 37 (39%) osteoarthritis and 20 (21%) lower back pain; 30 (32%) were treated with opioids. In summary, CNMP was common in the timely palliative care setting and many patients were on opioids. Our findings highlight the need to develop clinical guidelines for CNMP in cancer patients to standardize its management.
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Affiliation(s)
- David Hui
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
- Correspondence: ; Tel.: +1-713-794-1803; Fax: +1-713-792-6092
| | - Eman Abdelghani
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Joseph Chen
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Shiva Dibaj
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Donna Zhukovsky
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Rony Dev
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Kimberson Tanco
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Ali Haider
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Ahsan Azhar
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Akhila Reddy
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Daniel Epner
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Joseph Arthur
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Shalini Dalal
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Yvonne Heung
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Suresh Reddy
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Maxine De La Cruz
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
| | - Diane Liu
- Department of Biostatistics, MD Anderson Cancer Center, Houston, TX 77030, USA;
| | - Eduardo Bruera
- Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA; (E.A.); (J.C.); (S.D.); (D.Z.); (R.D.); (K.T.); (A.H.); (A.A.); (A.R.); (D.E.); (J.A.); (S.D.); (Y.H.); (S.R.); (M.D.L.C.); (E.B.)
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Prevalence of pain in patients with cancer aged 70 years or older: A prospective observational study. J Geriatr Oncol 2019; 10:637-642. [DOI: 10.1016/j.jgo.2019.01.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2018] [Revised: 11/16/2018] [Accepted: 01/07/2019] [Indexed: 12/27/2022]
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Pollak KI, Fish LJ, Sutton LM, Gao X, Lyna P, Owen L, Patel ML, Somers TJ. A smoking cessation and pain management program for cancer survivors. J Cancer Surviv 2018; 12:821-827. [PMID: 30328056 DOI: 10.1007/s11764-018-0719-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Accepted: 09/24/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Many cancer survivors continue to smoke. Further, most survivors also report high levels of persistent pain and smoke in response to pain. The investigators tested the feasibility, acceptability, and preliminary efficacy of a smoking cessation program paired with a pain management program for cancer survivors. METHODS The investigators conducted a two-arm, wait-list randomized controlled pilot study in which they delivered a combined smoking cessation and pain management intervention. RESULTS The investigators randomized 30 survivors (14 intervention and 16 wait-list control). Seventy-one percent of the survivors who received the intervention rated it as extremely useful (5 out of 5) in helping them quit smoking. Further, 86% would recommend the program to other survivors. Although we could not conduct inferential statistics, 14% of those in the intervention arm, compared to 6% in the control condition had biochemically validated cessation at 2-months post-randomization. Survivors in the intervention also reported less pain, had improvements in depressive symptoms, and better physical function than those in the control arm. CONCLUSIONS Our pilot data suggest the feasibility, acceptability, and preliminary efficacy of this approach. The next step is to conduct a large randomized controlled trial to fully test the efficacy of the intervention. IMPLICATIONS FOR CANCER SURVIVORS A combined smoking cessation and pain program might help improve both issues simultaneously.
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Affiliation(s)
- Kathryn I Pollak
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA. .,Department of Population Health Sciences, Duke School of Medicine, 2424 Erwin Road, Suite 602, Durham, NC, 27705, USA.
| | - Laura J Fish
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA.,Department of Medicine, Duke School of Medicine, Durham, NC, USA
| | - Linda M Sutton
- Duke Cancer Network, Duke Cancer Institute, Durham, NC, USA.,Department of Psychology and Neuroscience, Duke School of Medicine, Durham, NC, USA
| | - Xiaomei Gao
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA
| | - Pauline Lyna
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA
| | - Lynda Owen
- Duke Cancer Network, Duke Cancer Institute, Durham, NC, USA
| | - Michele L Patel
- Department of Psychiatry and Behavioral Sciences, Duke School of Medicine, Durham, NC, USA
| | - Tamara J Somers
- Cancer Control and Population Sciences, Duke Cancer Institute, Durham, NC, USA.,Faculty Practice in Psychiatry Erwin Square, Duke School of Medicine, 2200 W. Main Street Suite 340, Durham, NC, 27705, USA
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Anderson KO, Palos GR, Mendoza TR, Cleeland CS, Liao KP, Fisch MJ, Garcia-Gonzalez A, Rieber AG, Nazario LA, Valero V, Hahn KM, Person CL, Payne R. Automated pain intervention for underserved minority women with breast cancer. Cancer 2015; 121:1882-90. [PMID: 25711974 DOI: 10.1002/cncr.29204] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 08/15/2014] [Accepted: 09/02/2014] [Indexed: 12/26/2022]
Abstract
BACKGROUND Minority patients with breast cancer are at risk for undertreatment of cancer-related pain. The authors evaluated the feasibility and efficacy of an automated pain intervention for improving pain and symptom management of underserved African American and Latina women with breast cancer. METHODS Sixty low-income African American and Latina women with breast cancer and cancer-related pain were enrolled in a pilot study of an automated, telephone-based, interactive voice response (IVR) intervention. Women in the intervention group were called twice weekly by the IVR system and asked to rate the intensity of their pain and other symptoms. The patients' oncologists received e-mail alerts if the reported symptoms were moderate to severe. The patients also reported barriers to pain management and received education regarding any reported obstacles. RESULTS The proportion of women in both groups reporting moderate to severe pain decreased during the study, but the decrease was significantly greater for the intervention group. The IVR intervention also was associated with improvements in other cancer-related symptoms, including sleep disturbance and drowsiness. Although patient adherence to the IVR call schedule was good, the oncologists who were treating the patients rated the intervention as only somewhat useful for improving symptom management. CONCLUSIONS The IVR intervention reduced pain and symptom severity for underserved minority women with breast cancer. Additional research on technological approaches to symptom management is needed.
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Affiliation(s)
- Karen O Anderson
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Guadalupe R Palos
- Office of Cancer Survivorship, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Tito R Mendoza
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Charles S Cleeland
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Kai-Ping Liao
- Department of Health Services Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Michael J Fisch
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Araceli Garcia-Gonzalez
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Alyssa G Rieber
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - L Arlene Nazario
- Department of General Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Vicente Valero
- Department of Breast Medical Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Karin M Hahn
- London Regional Cancer Program, London Health Sciences Center, London, Ontario, Canada
| | - Cheryl L Person
- Department of Psychiatry and Behavioral Sciences, The University of Texas Health Sciences Center, Houston, Texas
| | - Richard Payne
- Duke Institute on Care at the End of Life, Duke University Divinity School, Durham, North Carolina
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