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survivorship
pain management

Chronic Pain in U.S. Cancer Survivors

In a study reported in a research letter in JAMA Oncology, Jiang et al found that 34.6% of cancer survivors in the United States report chronic pain and 16.1% report high-impact chronic pain. The study included data from 4,526 adult cancer survivors identified from 59,770 participants in the...

pain management

2019 ASCO: Pain Management Program for Patients Undergoing Robotic Urologic Surgery

A specialized pain management program for patients who underwent robotic surgery for urologic cancers resulted in 8% of patients going home with narcotics after discharge, compared to 100% who would have received them without this enhanced recovery protocol. The group of patients...

pain management

Single-Fraction Stereotactic vs Multifraction Radiotherapy for Pain Relief in Predominantly Nonspinal Bone Metastases

In a single-center phase II trial reported in JAMA Oncology, Nguyen et al found that single-fraction stereotactic body radiotherapy (SBRT) was associated with improved pain relief vs conventional multifraction radiotherapy in patients with mostly nonspinal bone metastases. In the noninferiority...

breast cancer
pain management

ASBrS 2019: Opioid Management Program Reduces Post–Breast Surgery Narcotic Use

A breast surgery opioid prescription management program that analyzed current physician patterns and provided education and guidelines successfully reduced the volume of narcotics given postoperatively to patients at a large institution. These results were presented by Fan et al at the Annual...

solid tumors
leukemia
prostate cancer
pain management

FDA Pipeline: Applications and Designations in Prostate Cancer, Leukemia, and HER2-Positive Cancers

In the past 2 weeks, the U.S. Food and Drug Administration (FDA) accepted a new drug application and granted Priority Review for a prostate cancer treatment, granted Orphan Drug designation to a treatment for acute lymphoblastic leukemia, accepted an investigational new drug application for a...

head and neck cancer
pain management

Doxepin or Diphenhydramine/Lidocaine/Antacid Mouthwash for Radiotherapy-Related Oral Mucositis Pain

In the phase III Alliance A221304 trial reported in JAMA, Sio et al found that doxepin mouthwash and diphenhydramine/lidocaine/antacid mouthwash reduced oral mucositis pain for the first 4 hours after administration in patients with oral mucositis pain from head and neck radiotherapy, but the...

pain management

Cost and Health-Care Utilization With Targeted Drug Delivery Plus Conventional Medical Management for Cancer-Related Pain

Results of a study published by Stearns et al in JAMA Network Open demonstrated a reduction in health-care utilization and cost for patients cancer-related pain using targeted drug delivery and conventional medical management vs conventional medical management alone. The study found...

issues in oncology
pain management

Opioid-Related Hospitalizations Among Patients With Cancer in the United States

In a study reported in a research letter in JAMA Oncology, Chua et al found that opioid-related hospitalizations among American patients with cancer are rare, increasing at a very low rate, and consist mostly of hospitalization for nonheroin opioid poisoning. The study analyzed trends and risk...

pain management

CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain in Patients With Cancer and Sickle Cell Disease

ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) are pleased to acknowledge receipt of a key clarification from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. ...

multiple myeloma
pain management

FDA Pipeline: Safety Warning About Investigational Use of Venetoclax in Multiple Myeloma, Warning Letter on Unapproved Products

This week, the U.S. Food and Drug Administration (FDA) posted a safety statement on the investigational use of venetoclax in multiple myeloma, and also posted a warning letter against a company for illegally marketing unapproved products labeled as homeopathic. Safety Statement The FDA posted...

breast cancer
colorectal cancer
lung cancer
pain management

Opioid Use Among Older Survivors of Colorectal, Lung, and Breast Cancers

In a linked Surveillance, Epidemiology, and End Results and Medicare study reported in the Journal of Clinical Oncology, Salz et al found that chronic opioid use varied by cancer among older cancer survivors. By 6 years after diagnosis, survivors were no more likely to be chronic opioid users...

issues in oncology
pain management

Charles von Gunten, MD, PhD, on Protecting Opioid Access for Patients in Need

Charles von Gunten, MD, PhD, of OhioHealth, discusses the critical need for opioids to manage cancer pain as well as the myth of addiction, which may impede best care.

supportive care
pain management

Mihir M. Kamdar, MD, on Managing Cancer-Related Pain With Artificial Intelligence

Mihir M. Kamdar, MD, of Massachusetts General Hospital, discusses study findings on a smartphone app called ePAL, which significantly reduces pain and pain-related hospital admissions by combining patient-reported outcome data and artificial intelligence via a telemedicine platform (Abstract 76).

palliative care
pain management

Leslie J. Blackhall, MD, on Unregulated Opioid Access: Consequences and Outcomes

Leslie J. Blackhall, MD, of the University of Virginia, discusses abuse of opioids, prescribing responsibly, and reducing cancer pain while also decreasing the risk of misusing these agents.

lung cancer
issues in oncology
pain management

Opioid Use Following Video-Assisted Thoracoscopic Surgery or Open Resection in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...

lung cancer
pain management

Study Shows Invasive Lung Cancer Surgery Can Lead to Long-Term Opioid Use

Patients treated with more invasive surgical techniques for early-stage non–small cell lung cancer (NSCLC) are more likely to become chronic opioid users than patients treated with minimally invasive surgery, highlighting the need for additional research into how pain management after surgery ...

issues in oncology
symptom management
pain management

Angela M. Stover, PhD, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).

issues in oncology
pain management

Jay B. Shah, MD, on Reducing Opioid Use After Urologic Oncology Surgery

Jay B. Shah, MD, of Stanford University, discusses the role that surgeons can play as gatekeepers to the opioid epidemic, including the view that complex cancer operations can be performed with little to no opioid use (Abstract 269).

issues in oncology
pain management
legislation

Fumiko Ladd Chino, MD, on Opioid-Associated Deaths in Patients With Cancer

Fumiko Ladd Chino, MD, of Duke University, discusses results from a population study she conducted of the opioid epidemic over the past 10 years and why these medications for cancer pain should continue to be excluded from restrictive-prescribing laws (Abstract 230).

issues in oncology
pain management

2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery

In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...

issues in oncology
pain management

2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population

According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...

issues in oncology
pain management

Statement by FDA Commissioner on Opioid Access for Patients With Chronic and End-of-Life Pain

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement. The opioid epidemic continues to take an emotional, physical, and financial toll on Americans. The FDA is committed to taking every possible step to address the many facets of this...

pain management

Effect of Integrated Assessment and Management Tool on Pain Management in Cancer Center Inpatients

In a UK-based study reported in the Journal of Clinical Oncology, Fallon et al found that adding a clinician-delivered bedside pain assessment and management tool (Edinburgh Pain Assessment and Management Tool [EPAT]) to usual care improved some pain outcomes in cancer center inpatients. Study...

breast cancer
pain management

SABCS 2017: Acupuncture May Reduce Joint Pain Caused by Aromatase Inhibitor Treatment

Acupuncture significantly reduced joint pain for postmenopausal women with early-stage breast cancer receiving treatment with an aromatase inhibitor compared with both sham acupuncture and no treatment, according to data from the randomized, phase III SWOG S1200 trial presented by Hershman et al at ...

pain management

Jenske Geerling, NP, on Painful Bone Metastases: Study Results on Nurse-Led Pain Education

Jenske Geerling, NP, of the University Medical Center Groningen, discusses findings from a multicenter trial on patient education, pain reduction, and quality of life (Abstract 203).

pain management

Jeremy Hirst, MD, on My Patient Needs Opiates and Benzodiazepines: What Should I Do?

Jeremy Hirst, MD, of the University of California, San Diego, offers concrete advice on assessing the need for these medications, using them safely, and knowing when to deprescribe them.

palliative care
pain management

Jacob J. Strand, MD, on Dealing With Opioid Use Disorders

Jacob J. Strand, MD, of the Mayo Clinic, discusses tips and tools that clinicians can use to develop universal precautions for prescribing opioids in oncology and palliative care practice.

pain management

Ontario Province–Wide Symptom Screening and Opioid Prescribing Rates in Older Patients With Cancer

In a study reported in the Journal of Oncology Practice, Barbera et al found that a province-wide effort to improve symptom screening and management has increased the frequency of screening but has not improved opioid prescription rates in elderly cancer patients with severe pain. A previous study...

survivorship
pain management

Higher Opioid Use Among Cancer Survivors

A new study found that opioid prescription use is more common in cancer survivors than in individuals without a history of cancer. This was true even among survivors who were 10 or more years past their cancer diagnosis. Published by Sutradhar et al in Cancer, the findings come at a time of rising...

pain management

FDA Requests Removal of Oxymorphone Hydrochloride for Risks Related to Abuse

On June 8,the U.S. Food and Drug Administration (FDA) requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated oxymorphone hydrochloride (Opana ER), from the market. After careful consideration, the agency is seeking removal based on its concern that the benefits of the...

symptom management
pain management

Peter Hoskin, MD, on Spinal Compression: Results From the SCORAD III Trial

Peter Hoskin, MD, of Mount Vernon Cancer Centre, discusses study findings on single-dose radiotherapy compared with multifraction radiotherapy in patients with metastatic spinal canal compression. (Abstract LBA10004)

pain management
symptom management

ASCO 2017: Single-Dose Radiotherapy as Effective as Multiple Fractions in Relieving Symptoms of Spinal Cord Compression

Spinal cord compression is a common complication in people with metastatic cancer and is a major detriment to quality of life. Radiation treatment is widely used to relieve pain and other symptoms, but there is no standard recommended schedule, and approaches currently vary. Findings from a phase...

issues in oncology
pain management

New Canadian Guideline Provides Advice to Physicians to Avoid Overprescribing of Opioids

Opioid overdoses are claiming the lives of thousands of Canadians. The impact of the opioid crisis continues to be devastating to individuals, families, and communities. Inappropriate prescribing of opioids has led to long-term dependence on this class of drugs. To help address problematic...

survivorship
pain management
breast cancer

Sophia Kustas Smith, PhD, MSW, on Depression and Fatigue: Self-Managed in 'Reimagine'

Sophia Kustas Smith, PhD, MSW, of Duke University, discusses study findings on an online, symptom self-management curriculum, known as www.reimagine.me, employed for breast cancer survivors with chronic pain (Abstract 182).

pain management

FDA Approves Morphine Sulfate Extended-Release Tablets Formulated With Abuse-Deterrent Properties

On January 9, the U.S. Food and Drug Administration (FDA) approved morphine sulfate extended-release tablets formulated with abuse-deterrent properties (Arymo ER) for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative...

pain management
global cancer care
palliative care

James F. Cleary, MD, on Global Access to Opioids

James F. Cleary, MD, of the University of Wisconsin Carbone Cancer Center, talks about the many reasons that 80% of the world’s population lacks access to opioids, the mainstay of cancer pain management.

palliative care
pain management
supportive care

Eduardo Bruera, MD, on Managing Opioid Use in Patients With a History of Addiction

Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center, discusses the need for outpatient palliative care programs to monitor and support these complex patients and their family members.

survivorship
pain management

ASCO Releases Clinical Practice Guideline on Management of Chronic Pain in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Judith A. Paice, PhD, RN, of Northwestern University, and colleagues, ASCO has released a clinical practice guideline on management of chronic pain in survivors of adult cancers. The guideline was based on literature review by an expert panel, with ...

pain management

Fentanyl Nasal Spray Now Available at a Dose of 300 μg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-μg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for...

pain management

Early Study Looks to Achieve Chloride Homeostasis Through Gene Transfer to Alleviate Cancer-Related Neuropathic Pain

A study providing new information about neuropathic pain afflicting some 90% of cancer patients who have had nerve damage caused by tumors, surgery, chemotherapy, or radiation indicates gene therapy as a possible treatment. The study in rats showed transfer of a gene known as KCC2 into the spinal...

pain management

Judith Paice, PhD, RN, on Managing Cancer Pain: Strategies for Prescribing Opioids

Judith Paice, PhD, RN, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, discusses strategies for safe opioid prescribing: making a comprehensive assessment, stratifying risk, using universal precautions, and educating practitioners on safe storage and disposal.

pain management
palliative care
symptom management
integrative oncology

Lorenzo Cohen, MD, on Acupuncture and Other Nondrug Pain Management Techniques

Lorenzo Cohen, MD, of The University of Texas MD Anderson Cancer Center, discusses nonpharmacologic approaches to symptom control. Techniques such as acupuncture for managing pain and chemotherapy-induced nausea and vomiting, or yoga and meditation to help improve quality of life, can be safely...

pain management

Judith Paice, PhD, RN, on Neuropathic Pain

Judith Paice, PhD, RN, of Northwestern University, reviews the current principles on assessing and treating neuropathic pain in cancer.

lung cancer
pain management

Brian D. Kavanagh, MD, on Improving Value and Elevating the Patient Care Experience

Brian D. Kavanagh, MD, of the University of Colorado School of Medicine, summarizes three papers: outcomes for locally advanced non–small cell lung cancer, 3D CRT vs image-guided intensity-modulated radiotherapy for reducing bowel toxicity, and dexamethasone for controlling pain flares in patients...

pain management

Pain, Still Undertreated and Misunderstood

Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor:  Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...

symptom management
palliative care
pain management

Samuel Chao, MD, on Improving the Consistency of Radiation Oncology Processes

Samuel Chao, MD, of Cleveland Clinic, discusses the QMAP program and data-driven management, which offer ways to improve consistency and drive quality in radiation oncology departments (Abstract 39).

palliative care
pain management
symptom management

Alysa M. Fairchild, MD, on Preventing Radiation-Induced Pain Flare

Alysa M. Fairchild, MD, of the Cross Cancer Institute and the University of Alberta, discusses her study on the use of dexamethasone to reduce pain flare in patients receiving palliative radiotherapy for bone metastases (Abstract LBA6663).

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