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Chronic Non-Malignant Pain in Patients with Cancer Seen at a Timely Outpatient Palliative Care Clinic

1
Department of Palliative Care, Rehabilitation and Integrative Medicine, MD Anderson Cancer Center, Houston, TX 77030, USA
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Department of Biostatistics, MD Anderson Cancer Center, Houston, TX 77030, USA
*
Author to whom correspondence should be addressed.
Cancers 2020, 12(1), 214; https://doi.org/10.3390/cancers12010214
Received: 7 December 2019 / Revised: 8 January 2020 / Accepted: 9 January 2020 / Published: 15 January 2020
(This article belongs to the Special Issue Palliative/Supportive Care )
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. View Full-Text
Keywords: analgesics; opioid; cancer-associated pain; chronic pain; neoplasms; palliative care; prevalence; therapeutics analgesics; opioid; cancer-associated pain; chronic pain; neoplasms; palliative care; prevalence; therapeutics
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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 2020, 12, 214.

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