Adult Cancer Pain, Version 3.2019, NCCN Clinical Practice Guidelines in Oncology

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Abstract

In recent years, the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Adult Cancer Pain have undergone substantial revisions focusing on the appropriate and safe prescription of opioid analgesics, optimization of nonopioid analgesics and adjuvant medications, and integration of nonpharmacologic methods of cancer pain management. This selection highlights some of these changes, covering topics on management of adult cancer pain including pharmacologic interventions, nonpharmacologic interventions, and treatment of specific cancer pain syndromes. The complete version of the NCCN Guidelines for Adult Cancer Pain addresses additional aspects of this topic, including pathophysiologic classification of cancer pain syndromes, comprehensive pain assessment, management of pain crisis, ongoing care for cancer pain, pain in cancer survivors, and specialty consultations.

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Most cited references 208

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Early Versus Delayed Initiation of Concurrent Palliative Oncology Care: Patient Outcomes in the ENABLE III Randomized Controlled Trial.

Marie Bakitas, Tor Tosteson, Zhigang Li … (2015)

Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use.

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Record: found
Abstract: found
Article: not found

Use of opioid analgesics in the treatment of cancer pain: evidence-based recommendations from the EAPC.

Augusto Caraceni, Geoffrey Hanks, Stein Kaasa … (2012)

Here we provide the updated version of the guidelines of the European Association for Palliative Care (EAPC) on the use of opioids for the treatment of cancer pain. The update was undertaken by the European Palliative Care Research Collaborative. Previous EAPC guidelines were reviewed and compared with other currently available guidelines, and consensus recommendations were created by formal international expert panel. The content of the guidelines was defined according to several topics, each of which was assigned to collaborators who developed systematic literature reviews with a common methodology. The recommendations were developed by a writing committee that combined the evidence derived from the systematic reviews with the panellists' evaluations in a co-authored process, and were endorsed by the EAPC Board of Directors. The guidelines are presented as a list of 16 evidence-based recommendations developed according to the Grading of Recommendations Assessment, Development and Evaluation system. Copyright © 2012 Elsevier Ltd. All rights reserved.

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Record: found
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Article: not found

Pain and its treatment in outpatients with metastatic cancer.

C Cleeland, R Gonin, A Hatfield … (1994)

Pain is often inadequately treated in patients with cancer. A total of 1308 outpatients with metastatic cancer from 54 treatment locations affiliated with the Eastern Cooperative Oncology Group rated the severity of their pain during the preceding week, as well as the degree of pain-related functional impairment and the degree of relief provided by analgesic drugs. Their physicians attributed the pain to various factors, described its treatment, and estimated the impact of pain on the patients' ability to function. We assessed the adequacy of prescribed analgesic drugs using guidelines developed by the World Health Organization, studied the factors that influenced whether analgesia was adequate, and determined the effects of inadequate analgesia on the patients' perception of pain relief and functional status. Sixty-seven percent of the patients (871 of 1308) reported that they had had pain or had taken analgesic drugs daily during the week preceding the study, and 36 percent (475 of 1308) had pain severe enough to impair their ability to function. Forty-two percent of those with pain (250 of the 597 patients for whom we had complete information) were not given adequate analgesic therapy. Patients seen at centers that treated predominantly minorities were three times more likely than those treated elsewhere to have inadequate pain management. A discrepancy between patient and physician in judging the severity of the patient's pain was predictive of inadequate pain management (odds ratio, 2.3). Other factors that predicted inadequate pain management included pain that physicians did not attribute to cancer (odds ratio, 1.9), better performance status (odds ratio, 1.8), age of 70 years or older (odds ratio, 2.4), and female sex (odds ratio, 1.5). Patients with less adequate analgesia reported less pain relief and greater pain-related impairment of function. Despite published guidelines for pain management, many patients with cancer have considerable pain and receive inadequate analgesia.

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Author and article information

Journal

Title: Journal of the National Comprehensive Cancer Network

Publisher: Harborside Press, LLC

ISSN (Print): 1540-1405

ISSN (Electronic): 1540-1413

Publication date Created: August 2019

Publication date (Print): August 2019

Volume: 17

Issue: 8

Pages: 977-1007

Affiliations

[1 ]1Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine;

[2 ]2Robert H. Lurie Comprehensive Cancer Center of Northwestern University;

[3 ]3St. Jude Children’s Research Hospital/The University of Tennessee Health Science Center;

[4 ]4Fred & Pamela Buffett Cancer Center;

[5 ]5University of Wisconsin Carbone Cancer Center;

[6 ]6City of Hope National Medical Center;

[7 ]7Fox Chase Cancer Center;

[8 ]8The University of Texas MD Anderson Cancer Center;

[9 ]9Moffitt Cancer Center;

[10 ]10The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute;

[11 ]11Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance;

[12 ]12Roswell Park Comprehensive Cancer Center;

[13 ]13Duke Cancer Institute;

[14 ]14Massachusetts General Hospital Cancer Center;

[15 ]15Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute;

[16 ]16Stanford Cancer Institute;

[17 ]17Vanderbilt-Ingram Cancer Center;

[18 ]18Memorial Sloan Kettering Cancer Center;

[19 ]19O’Neal Comprehensive Cancer Center at UAB;

[20 ]21Abramson Cancer Center at the University of Pennsylvania;

[21 ]22UCSF Helen Diller Family Comprehensive Cancer Center;

[22 ]23Dana-Farber/Brigham and Women’s Cancer Center;

[23 ]24UC San Diego Moores Cancer Center;

[24 ]25Huntsman Cancer Institute at the University of Utah;

[25 ]26University of Michigan Rogel Cancer Center;

[26 ]27University of Colorado Cancer Center; and

[27 ]28National Comprehensive Cancer Network

Article

DOI: 10.6004/jnccn.2019.0038

PubMed ID: 31390582

SO-VID: b16f0185-f1d1-4d74-afa0-5ebe7e423b5f

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