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Alyssa A. Schatz, Thomas K. Oliver, Robert A. Swarm, Judith A. Paice, Deepika S. Darbari, Deborah Dowell, Salimah H. Meghani, Katy Winckworth-Prejsnar, Eduardo Bruera, Robert M. Plovnick, Lisa Richardson, Neha Vapiwala, Dana Wollins, Clifford A. Hudis and Robert W. Carlson

to curb inappropriate opioid use, has led to significant barriers for many cancer patients when opioid use is clinically indicated for pain management. 1 , 2 Pain management is complex and multifactorial. Clinical practice guidelines from leading

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Anthony Eidelman, Traci White and Robert A. Swarm

Optimized use of systemic analgesics fails to adequately control pain in some patients with cancer. Commonly used analgesics, including opioids, nonopioids (acetaminophen and non-steroidal anti-inflammatory drugs), and adjuvant analgesics (anticonvulsants and antidepressants), have limited analgesic efficacy, and their use is often associated with adverse effects. Without adequate pain control, patients with cancer not only experience the anguish of poorly controlled pain but also have greatly diminished quality of life and may even have reduced life expectancy. Interventional pain therapies are a diverse set of procedural techniques for controlling pain that may be useful when systemic analgesics fail to provide adequate control of cancer pain or when the adverse effects of systemic analgesics cannot be managed reasonably. Commonly used interventional therapies for cancer pain include neurolytic neural blockade, spinal administration of analgesics, and vertebroplasty. Compared with systemic analgesics, which generally have broad indications for control of pain, individual interventional therapies generally have specific, narrow indications. When appropriately selected and implemented, interventional pain therapies are important components of broad, multimodal cancer pain management that significantly increases the proportion of patients able to experience adequate pain control.

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Natalie Moryl, Nessa Coyle, Samuel Essandoh and Paul Glare

-administered pain interview and assessment battery focusing on pain, quality of life, and psychological distress. 12 The prevalence of pain in cancer survivors depends on the type of cancer, comorbid conditions, and initial pain management. For example, pain was

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Judith A. Paice

. A systematic review of the adequacy of analgesic therapy in patients with cancer suggested that the quality of pharmacologic pain management has improved since 1994, but much still needs to be done to meet the needs of this population. 4

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Paolo Marchetti, Raymond Voltz, Carmen Rubio, Didier Mayeur and Andreas Kopf

available on optimal ways to develop successful programs. The availability of palliative care and pain management services varies by country and geographic location, and across medical centers. Programs incorporating palliative care services must base their

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Rehab Abdelwahab, Anas Hamad, Randa Al Okka, Mohd A. Wahid, Khalil Ullah Shibli, Wael Saleem, Ahmed El Geziry, Fathi Saleh, Kakil Rasul and Shereen Elazzazy

may prescribe analgesics to their patients or refer them to the Pain Management Service (PMS) based on their evaluation or as requested by patients. This study explored the factors which might lead to undertreatment of cancer pain in Qatar. In addition

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Rehab Abdelwahab, Anas Hamad, Shereen El Azzaz, Randa Al Okka, Mohd A. Wahid, Khalil Ullah Shibli, Ahmed El Geziry, Fathi Saleh, Kakil Rasul and Wael Saleem

assess pain, which might affect drug selection and pain control (Stewart, Ulster Med J 2014). In NCCCR, the treating primary physicians (PP) may prescribe analgesics to their patients or refer them to the Pain Management Team (PMT), based on evaluation or

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William Bensinger, Mark Schubert, Kie-Kian Ang, David Brizel, Elizabeth Brown, June G. Eilers, Linda Elting, Bharat B. Mittal, Mark A. Schattner, Ricardo Spielberger, Nathaniel S. Treister and Andy M. Trotti III

OM requires multidisciplinary involvement. Severe OM requiring hospital admission may be best managed by a pain management team. General Treatment Strategies Although risk assessment and preventive strategies vary based on whether the patient is

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Jana Portnow, Christine Lim and Stuart A. Grossman

. Pain 1994 ; 6 : 299 – 306 . 14 Ward SE Gordon DB . Patient satisfaction and pain severity as outcomes in pain management: a longitudinal view of one setting's experience . J Pain Symptom Manage 1996 ; 11 : 242 – 251 . 15

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Sharon M. Weinstein, Dorothy Romanus, Eva M. Lepisto, Cielito Reyes-Gibby, Charles Cleeland, Rex Greene, Cameron Muir and Joyce Niland

The National Comprehensive Cancer Network (NCCN), an organization of 19 of the world's leading cancer centers, developed and communicated a cancer pain treatment guideline. NCCN seeks to implement guidelines through performance measurement using a NCCN Oncology Outcomes Database. This is a preliminary report from the NCCN Cancer Pain Management Database Project. The primary objective of this NCCN Cancer Pain Management Database Project study is to evaluate the frequency, methods, and extent of documentation of cancer pain assessment and managementat NCCN institutions. A pain data dictionary and related data collection forms were first developed. The records of 209 breast cancer patients with bone metastases were then studied. The frequency of pain mentions, type of pain assessment tool used, pain characteristics, type of clinician documenting pain, location in the medical record, and pain treatment characteristics were noted. The majority of clinical encounters included pain mentions, although considerable variability was found in pain documentation between providers and between inpatient and outpatient settings. Nurses more frequently recorded pain, usually as a numeric pain intensity score. Pain specialists were more likely to record a complete description of pain. A significant minority of patients experienced moderate to severe pain. In a small subgroup of patients with moderate to severe pain, pain treatment was not recorded. The undertreatment of cancer pain has been a focus of investigation and review for the past two decades. Quality improvement efforts to raise the standard of pain management have been underway. The results of this study highlight the need for standardization of pain documentation in comprehensive cancer centers as a prerequisite for the proper assessment of cancer pain and the improvement of clinical outcomes of pain management.