Guidelines Issued for Managing Chronic Pain in Cancer Survivors
Recurrent disease, second malignancy, late-onset treatment effects should be assessed in patients with new pain.
(HealthDay News) -- Guidelines have been developed for chronic pain management in adult cancer survivors. The American Society of Clinical Oncology Clinical Practice Guideline was published online in the Journal of Clinical Oncology.
Judith A. Paice, PhD, RN, from the Northwestern University Feinberg School of Medicine in Chicago, and colleagues conducted a systematic literature search of studies examining chronic pain management in cancer survivors to provide evidence-based guidelines on optimum management. Sixty-three studies were included as the evidentiary basis for the recommendations.
The researchers note that, at each encounter, clinicians should screen for pain. In any patient who reports new-onset pain, recurrent disease, secondary malignancy, or late-onset treatment effects should be assessed, treated, and monitored. In patients with complex needs, clinicians should assess the need for other health professionals to provide comprehensive pain management care.
To relieve chronic pain and/or improve function, systemic non-opioid analgesics and adjuvant analgesics may be prescribed. A trial of opioids may be prescribed in selected patients who do not respond to more conservative management; risks of adverse effects of opioids should be assessed. Clinicians should understand concepts such as tolerance, dependence, abuse, and addiction as they relate to opioid use.
"Numerous gaps in existing evidence have been identified and highlighted in this guideline," the authors write. "Comprehensive assessment, including the impact of pain on function and quality of life, is warranted for all survivors."
Several authors disclosed financial ties to the pharmaceutical industry.
1. Paice JA, Portenoy R, Lacchetti C, et al. Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline. JCO 2016 Jul 25. doi: 10.1200/JCO.2016.68.5206.