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      Managing Pain in Patients With Cancer: The Chinese Good Pain Management Experience

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          Abstract

          Purpose

          The number of cancer cases in China has increased rapidly from 2.1 million in 2000 to 4.3 million in 2015. As a consequence, pain management as an integral part of cancer treatment became an important health care issue. In March 2011, the Good Pain Management (GPM) program was launched to standardize the treatment of cancer pain and improve the quality of life for patients with cancer. With this work, we will describe the GPM program, its implementation experience, and highlight key lessons that can improve pain management for patients with cancer.

          Methods

          We describe procedures for the selection, implementation, and assessment procedures for model cancer wards. We analyzed published results in areas of staff training and patient education, pain management in practice, analgesic drugs administration, and patient follow-up and satisfaction.

          Results

          Pain management training enabled medical staff to accurately assess the level of pain and to provide effective pain relief through timely dispensation of medication. Patients with good knowledge of treatment of pain were able to overcome their aversion to opioid drugs and cooperate with nursing staff on pain assessment to achieve effective drug dose titration. Consumption of strong opioid drugs increased significantly; however, there was no change for weaker opioids. Higher pain remission rates were achieved for patients with moderate-to-severe pain levels. Proper patient follow-up after discharge enabled improved outcomes to be maintained.

          Conclusion

          The GPM program has instituted a consistent and high standard of care for pain management at cancer wards and improved the quality of life for patients with cancer.

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          Most cited references34

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          Estimates of cancer incidence in China for 2000 and projections for 2005.

          Knowledge of the incidence of cancer is a fundamental requirement of rational planning and monitoring of cancer control programs. The lack of national-level information systems on health indicators in China means that estimation methods are required. Estimates and projections of national level cancer mortality have been previously made using sample surveys of deaths. Using these mortality data, incidence rates in 2000 and 2005 were estimated by means of the ratio of cancer cases/deaths (by site, age, and sex) in good quality cancer registries in China. A total of 2.1 million cancer cases were estimated for the year 2000 (1.3 million in men, 0.8 million in women), with the most common sites being lung, liver, and stomach in men, and breast, lung, and stomach in women. The total number of new cases is expected to increase by 14.6% by 2005, primarily as a result of population growth and aging. In addition, the rising rates of lung cancer incidence (in both sexes) and breast cancer mean that there will be much greater increases in the number of cases at these two sites (27% for lung cancer in men, 38% for lung and breast cancer in women). These two cancers are now the priorities for cancer prevention, early detection, and therapy in China.
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            GLOBOCAN 2020: Estimated Cancer Incidence, Mortality and Prevalence Worldwide in 2020

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              The doctor's dilemma: opiate analgesics and chronic pain.

              Opiates are utilized routinely and effectively as a short-term analgesic treatment for a variety of acute pain conditions such as occur following trauma, and for patients with painful terminal diseases such as cancer. Because opiate analgesics are highly addictive substances, their use in the treatment of chronic nonmalignant pain remains controversial.
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                Author and article information

                Journal
                J Glob Oncol
                J Glob Oncol
                jgo
                jgo
                JGO
                Journal of Global Oncology
                American Society of Clinical Oncology
                2378-9506
                October 2017
                21 September 2016
                : 3
                : 5
                : 583-595
                Affiliations
                [1] Shi-Ying Yu, Huazhong University of Science and Technology and Tongji Hospital, Wuhan; Jie-Jun Wang, Shanghai Changzheng Hospital, Shanghai; Yu-guang Huang, Peking Union Medical College Hospital; Ping Ping Li, Beijing University Cancer Hospital, Beijing; Bing Hu, Anhui Provincial Hospital, Anhui; Kun Wang, Tianjin Medical University Cancer Institute and Hospital, National Clinical Research Center for Cancer, Tianjin; Yi-Long Wu, Guangdong Lung Cancer Institute, Guangdong General Hospital, Guangdong; He-Long Zhang, Tangdu Hospital and Tangdu Comprehensive Cancer Center, Cancer Institute, 4th Military Medical University, Xi'an; Li Zhang, Sun Yat-Sen University Cancer Center, Guangzhou; Qing-Yuan Zhang, 3rd Affiliated Hospital of Harbin Medical University, Harbin, Heilongjiang; and Shu-Kui Qin, The People's Liberation Army Cancer Centre, Nanjing Bayi Hospital, Nanjing, Jiangsu, People’s Republic of China.
                Author notes
                Corresponding author: Shu-Kui Qin, MD, The People's Liberation Army Cancer Centre, Nanjing Bayi Hospital, Nanjing, Jiangsu, 210002, People’s Republic of China; e-mail: qinsk@ 123456csco.org.cn .

                S.-Y.Y. and J.-J.W. contributed equally to this work.

                Article
                005686
                10.1200/JGO.2016.005686
                5646883
                29094098
                c2c1a3fe-4418-4224-b552-f661c7213b3f
                © 2016 by American Society of Clinical Oncology

                Licensed under the Creative Commons Attribution 4.0 License: http://creativecommons.org/licenses/by/4.0/.

                History
                Page count
                Figures: 1, Tables: 5, Equations: 0, References: 37, Pages: 13
                Categories
                HSR2, Quality of Care
                HSR3, Policy Analysis
                CMPL1, Pain Control
                CMPL4, Supportive Care
                Review Articles
                Custom metadata
                v1

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