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Special Issue "Strategies for Cancer Pain Management"

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A special issue of Cancers (ISSN 2072-6694). This special issue belongs to the section "Cancer Survivorship and Quality of Life".

Deadline for manuscript submissions: 5 April 2024 | Viewed by 2735

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Special Issue Editor

Prof. Dr. Sebastiano Mercadante

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Guest Editor

Main Regional Center for Pain Relief & Palliative Care Unit, La Maddalena Cancer Center, Via San Lorenzo 312, 90146 Palermo, Italy
Interests: cancer pain; opioids; palliative care
Special Issues, Collections and Topics in MDPI journals

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Dear Colleagues,

Despite increased attention to cancer pain, pain prevalence in patients with cancer has not significantly changed over the last several decades. Over one-third of patients receiving anticancer therapy suffer from moderate-to-severe pain, and about 50% of the population in the advanced stage of disease has moderate-to-severe pain. The lack of improvement is due to barriers for patients to report pain, poor pain assessment, limited education and knowledge of available analgesic treatments, and limitations of pharmacological treatments. In the last several years, the opioid crisis has also influenced the proper use of opioid analgesics, which remain fundamental for cancer pain management.

Cancer pain is a complex issue that requires specific competence and knowledge of all available methods to relieve it. Despite the extensive experience suggesting the feasibility and efficacy of the WHO method, this approach is just a general recommendation and has been erroneously considered the gold standard of cancer pain management usable by anyone. It is evident that in the third century, the different situations of cancer pain cannot be included in the three-step ladder, and that any specific clinical circumstance requires profound knowledge of all available pharmacological and non-pharmacological techniques.

This Special Issue will highlight the role of different strategies for assessing and treating cancer pain.

Prof. Dr. Sebastiano Mercadante
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

cancer pain
palliative care
opioids
analgesics
management

Published Papers (3 papers)

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Research

13 pages, 431 KiB

Open AccessArticle

Immunoassay Urine Drug Testing among Patients Receiving Opioids at a Safety-Net Palliative Medicine Clinic

and

Cancers 2023, 15(23), 5663; https://doi.org/10.3390/cancers15235663 - 30 Nov 2023

Viewed by 219

Abstract

Background: Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics. Objectives: We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic. Methods: A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results. Results: Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03–4.38; p = 0.04), history of illicit drug use (OR = 3.57; CI: 1.78–7.13; p < 0.001), and history of marijuana use (OR = 7.05; CI: 3.85–12.91; p < 0.001) were independent predictors of an aberrant UDT finding. Conclusion: Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings. Full article

(This article belongs to the Special Issue Strategies for Cancer Pain Management)

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11 pages, 261 KiB

Open AccessEditor’s ChoiceArticle

Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

and

Cancers 2023, 15(14), 3676; https://doi.org/10.3390/cancers15143676 - 19 Jul 2023

Cited by 1 | Viewed by 682

Abstract

Opioid switching is a common practice of substituting one opioid for another to improve analgesia or adverse effects; however, it has limited evidence. This study aimed to examine the effectiveness of opioid switching in advanced cancer. This multi-center prospective cohort study recruited patients assessed to switch opioids (opioid switch group) or to continue ongoing opioid treatment (control group). Clinical data (demographics, opioids) and validated instruments (pain and adverse effects) were collected over two timepoints seven days apart. Descriptive analyses were utilized. Non-parametric tests were used to determine differences. Fifty-four participants were recruited (23 control group, 31 switch group). At the follow-up, opioid switching reduced pain (worst, average, and now) (p < 0.05), uncontrolled breakthrough pain (3-fold reduction, p = 0.008), and psychological distress (48% to 16%, p < 0.005). The switch group had a ≥25% reduction in the reported frequency of seven moderate-to-severe adverse effects (score ≥ 4), compared to a reduction in only one adverse effect in the control group. The control group experienced no significant pain differences at the follow-up. Opioid switching is effective at reducing pain, adverse effects, and psychological distress in a population with advanced cancer pain, to levels of satisfactory symptom control in most patients within 1 week. Full article

(This article belongs to the Special Issue Strategies for Cancer Pain Management)

15 pages, 1344 KiB

Open AccessArticle

The Prevalence of Back Pain in Patients Operated on Due to Colorectal Cancer Depending on the Type of Surgical Procedure Performed

Iwona Głowacka-Mrotek

Michał Jankowski

Bartosz Skonieczny

Magdalena Tarkowska

Dorota Ratuszek-Sadowska

and

Magdalena Mackiewicz-Milewska

Cancers 2023, 15(8), 2298; https://doi.org/10.3390/cancers15082298 - 14 Apr 2023

Viewed by 1118

Abstract

Purpose: Low back pain presents a serious challenge for numerous medical specialties. The purpose of this study was to assess disability due to low back pain in patients operated on due to colorectal cancer depending on the type of surgery performed. Methods: This prospective observational study was carried out in the period of July 2019 through March 2020. Included in the study were patients with colorectal cancer for scheduled surgeries including anterior resection of rectum (AR), laparoscopic anterior resection of rectum (LAR), Hartmann’s procedure (HART), or abdominoperineal resection of rectum (APR). The Oswestry Low Back Pain Disability Questionnaire was used as the research tool. The study patients were surveyed at three time points: before surgery, six months after surgery, and one year after surgery. Results: The analysis of study results revealed that an increase in the degree of disability and functioning impairment occurred in all groups between time points I and II, with the differences being statistically significant (p < 0.05). The inter-group comparative analysis of the total Oswestry questionnaire scores revealed statistically significant differences, with the impairment of function being most severe within the APR group and least severe within the LAR group. Conclusion: The study results showed that low back pain contributes to impaired functioning of patients operated on due to colorectal cancer regardless of the type of procedure performed. A reduction in the degree of disability due to low back pain was observed one year after the procedure in patients having undergone LAR. Full article

(This article belongs to the Special Issue Strategies for Cancer Pain Management)

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