open access

Vol 5, No 2 (2009)
Guidelines / Expert consensus
Published online: 2009-04-20
Get Citation

Consensus statement with focus on cancer pain management

Jan Dobrogowski, Małgorzata Krajnik, Jacek Jassem, Jerzy Wordliczek
Onkol. Prak. Klin 2009;5(2):55-68.

open access

Vol 5, No 2 (2009)
EXPERTS' OPINION
Published online: 2009-04-20

Abstract

In Poland, malignant diseases claim over 80 thousand lives annually. Pain may appear at any stage of cancer and manifests itself, on average, in 50% of patients, and at advanced stages of the disease - in over 75% of patients. The pain accompanying cancers is varied, as are its underlying mechanisms. Depending on its aetiology, pain may be related to the disease process itself, to the anti-cancer treatment and to cancerrelated wasting. There is also coexistent pain unrelated to the underlying disease process. Pharmacotherapy constitutes the basic method of pain treatment in cancer patients. In 1986, the World Health Organization proposed and introduced a simple formula for pharmacological treatment of cancer pain, whose practical application is effective in 85–90% of patients and whose principles are reviewed in this study. The paper also presents other, non-pharmacological methods of pain treatment (ones that modify the course of the disease, physical therapy, psychological therapy, methods that improve the quality of life, as well as blocks and neurolytic procedures). The article concludes with a discussion of issues related to the treatment of total pain and pain in the process of dying.

Abstract

In Poland, malignant diseases claim over 80 thousand lives annually. Pain may appear at any stage of cancer and manifests itself, on average, in 50% of patients, and at advanced stages of the disease - in over 75% of patients. The pain accompanying cancers is varied, as are its underlying mechanisms. Depending on its aetiology, pain may be related to the disease process itself, to the anti-cancer treatment and to cancerrelated wasting. There is also coexistent pain unrelated to the underlying disease process. Pharmacotherapy constitutes the basic method of pain treatment in cancer patients. In 1986, the World Health Organization proposed and introduced a simple formula for pharmacological treatment of cancer pain, whose practical application is effective in 85–90% of patients and whose principles are reviewed in this study. The paper also presents other, non-pharmacological methods of pain treatment (ones that modify the course of the disease, physical therapy, psychological therapy, methods that improve the quality of life, as well as blocks and neurolytic procedures). The article concludes with a discussion of issues related to the treatment of total pain and pain in the process of dying.
Get Citation

Keywords

cancer patients; pain mechanisms; pain management; opioids

About this article
Title

Consensus statement with focus on cancer pain management

Journal

Oncology in Clinical Practice

Issue

Vol 5, No 2 (2009)

Article type

Guidelines / Expert consensus

Pages

55-68

Published online

2009-04-20

Bibliographic record

Onkol. Prak. Klin 2009;5(2):55-68.

Keywords

cancer patients
pain mechanisms
pain management
opioids

Authors

Jan Dobrogowski
Małgorzata Krajnik
Jacek Jassem
Jerzy Wordliczek

References (14)
  1. Deandrea S, Montanari M, Moja L, et al. Prevalence of undertreatment in cancer pain. A review of published literature. Ann Oncol. 2008; 19(12): 1985–1991.
  2. World Health Organization.. Cancer pain relief (2 nd ed.). World Health Organization, Geneva 1996: Geneva.
  3. Radbruch L, Nauck F, Hanks GW, et al. European Association for Palliative Care(EAPC), Expert Working Group of the Research Network of the European Association for Palliative Care. Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer. 2001; 84(5): 587–593.
  4. Attal N, Cruccu G, Haanpää M, et al. EFNS guidelines on pharmacological treatment of neuropathic pain. European Journal of Neurology. 2006; 13(11): 1153–1169.
  5. Jost L, Roila F, Jost L, et al. ESMO Guidelines Working Group, ESMO Guidelines Working Group. Management of cancer pain: ESMO clinical recommendations. Ann Oncol. 2008; 19 Suppl 2: ii119–ii121.
  6. NCCN Clinical Practise Guidelines in Oncology. Ból nowotworowy u dorosłych. National Comprehensive Cancer Network 2007.
  7. Dworkin RH, O'Connor AB, Backonja M, et al. Pharmacologic management of neuropathic pain: evidence-based recommendations. Pain. 2007; 132(3): 237–251.
  8. Pergolizzi J, Böger RH, Budd K, et al. Opioids and the management of chronic severe pain in the elderly: consensus statement of an International Expert Panel with focus on the six clinically most often used World Health Organization Step III opioids (buprenorphine, fentanyl, hydromorphone, methadone, morphine, oxycodone). Pain Pract. 2008; 8(4): 287–313.
  9. Twycross R., Wilcock A. Palliative Care Formulary (3 rd ed.). www.palliativedrugs.com.
  10. Mercadante S. Opioid titration in cancer pain. In: Pain 2008 an updated review. Refresher Course Syllabus, IASP Press, Seattle 2008: 13–18.
  11. Wordliczek J, Dobrogowski J. Leczenie bólu. Wydawnictwo Lekarskie PZWL, Warszawa 2007.
  12. Dobrogowski J, Przeklasa-Muszyńska A, Woroń J, et al. Zasady kojarzenia leków w terapii bólu. Med Paliat Prakt. 2007; 1: 6–15.
  13. Dobrogowski J, Wordliczek J. Ból w chorobie nowotworowej. W: Krzemieniecki K. (red.). Leczenie wspomagające w onkologii. Termedia, Poznań 2008: 136–149.
  14. Jarosz J, Hilgier M, Kaczmarek Z, de Walden-Gałuszko K. Leczenie bólów nowotworowych. In: Zalecenia postępowania diagnostyczno-terapeutycznego w nowotworach złośliwych 2009 r. Część I. Via Medica, Gdańsk 2009.

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

Wydawcą serwisu jest  "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk

tel.:+48 58 320 94 94, faks:+48 58 320 94 60, e-mail:  viamedica@viamedica.pl