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Survivorship
Pain Management
Symptom Management

First Survivor Views Survey Highlights Barriers to Addressing Side Effects of Cancer Treatment

Barriers to accessing appropriate therapies to address the physical and psychological side effects of cancer treatment continue to persist for patients and survivors, according to results of the Survivor Views survey conducted by the American Cancer Society Cancer Action Network (ACS CAN)....

Supportive Care
Pain Management

2019 Supportive Care: Anxiety, Depression, and Low Social Support Are Significant Factors in Cancer Pain Intensity

Pain is one of the most common symptoms associated with cancer and its treatment, and feelings of anxiety and depression can intensify the level of pain patients experience, according to the results from a study by Galloway et al that will be presented at the 2019 Supportive Care in Oncology...

Issues in Oncology
Pain Management

Access to Cannabis Products for Patients With Cancer in a State With Restrictive Medical Marijuana Laws

Results of a survey reported by Singh et al in the Journal of Oncology Practice found that a population of primarily patients with cancer enrolled in Georgia’s medical marijuana program reported concerns about the legality of marijuana-related products and their ability to obtain the products. As...

Symptom Management
Pain Management

2019 Quality Care: Improving Documentation of Pain and Constipation Assessment and Management

In a study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Chineke et al found that a Quality Oncology Practice Initiative (QOPI) initiated in collaboration with ASCO at the Georgia Cancer Center for Excellence (GCCE) at Grady Health...

Issues in Oncology
Pain Management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

Supportive Care
Palliative Care
Pain Management

How an Innovative AI-Based Smartphone Application Is Addressing Patients’ Palliative Care Needs

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD, FASCO. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   During the 2019...

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

New Infographic, Commentaries Highlight Role of Opioids in Managing Cancer-Related Pain

As part of ASCO’s State of Cancer Care in America initiative, the Journal of Oncology Practice recently published an infographic about opioids and cancer pain, which highlights the specific needs of patients with cancer and some of the hurdles they face in trying to access prescribed opioids to...

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
Health-Care Policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

Pain Management

CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain

ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) recently acknowledged receipt of a key clarification1 from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. The clarification...

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
Issues in Oncology
Supportive Care

Opioid Toolkit: Helping Nebraskan Hospitals to Provide Appropriate Pain Management

As the opioid epidemic continues to sweep the United States, providers across Nebraska are facing the challenge of determining the appropriateness of pain treatment options that both meet the needs of the patients and fall within nationally published guidelines. A recent report published by the...

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...

Lung Cancer
Pain Management

Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic 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....

Pain Management
Supportive Care

Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer

In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...

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.

Supportive Care
Pain Management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

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...

Legislation
Pain Management

New Laws Limiting Opioid Prescriptions Create Undue Barriers for Patients With Cancer and Cancer Survivors

Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...

Pain Management

Expert Point of View: Ian Olver, AM, MD, PhD

Though many case studies and anecdotal reports have touted the effectiveness of cannabinoids for cancer pain, in randomized studies, the areas in which they are effective are “fairly borderline,” according to Ian Olver, AM, MD, PhD, Immediate Past President of the Multinational Association of...

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...

Gynecologic Cancers
Pain Management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

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...

Solid Tumors
Colorectal Cancer
Supportive Care
Pain Management
Palliative Care
Survivorship
Issues in Oncology

Support, Inform Patients With ASCO Resources

Stock your practice with ASCO resources for your patients. Visit ASCO’s patient information website, Cancer.Net, for a newly updated comprehensive guide to colorectal cancer at cancer.net/colorectal and a shorter, one-page colorectal cancer fact sheet. Copies can be purchased from the ASCO...

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 ...

Issues in Oncology
Pain Management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

Pain Management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

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
Supportive Care

Pediatric Cancer Pain May Be Misunderstood and Largely Undertreated

Cancer pain in children poses certain unique challenges. Over the past decade, insightful research into pediatric cancer pain has focused on pain management that incorporates nonopioid therapies into standard care. To shed light on this important issue, The ASCO Post spoke with Christine T....

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...

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