Pain Remains Prevalent in Ambulatory Cancer
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(HealthDay News) — For ambulatory patients with solid tumors, pain is prevalent and changes over time, according to a study published online Dec. 23 in the Journal of Clinical Oncology.
Fengmin Zhao, PhD, from the Dana-Farber Cancer Institute in Boston, and colleagues analyzed patient-rated pain levels (0 to 10 scale) at baseline and 4 to 5 weeks later in a cohort of 2,761 ambulatory patients with invasive cancer of the breast, prostate, colon/rectum, or lung from multiple sites. The changes in pain severity were assessed over time, with a clinically significant change in pain defined as a two-point change.
The researchers found that 53.0% of patients had no pain, 23.5% had mild pain, 10.3% had moderate pain, and 13.2% had severe pain at initial assessment. Of the patients with initial pain, one-third had pain reduction within 1 month of follow-up and one-fifth had an increase.
Improvement or worsening of pain varied according to the baseline pain score. More than a quarter of the patients without pain at initial assessment (28.4%) had pain at follow-up assessment, with 8.9% reporting moderate to severe pain.
Pain deterioration correlated significantly with inadequate pain management and with lower baseline pain level, younger age, and poor health status.
"In conclusion, pain remains a significant concern in ambulatory oncology," the authors wrote. "Pain is not only prevalent but also persistent and dynamic."