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."


  1. Zhao F, Chang VT, Cleeland C, et al. Determinants of Pain Severity Changes in Ambulatory Patients With Cancer: An Analysis From Eastern Cooperative Oncology Group Trial E2Z02. J Clin Oncol. 2013;doi:10.1200/JCO.2013.50.6071.

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