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Pain Management

Comparative Effectiveness of Acupuncture vs Massage for Relieving Pain in Patients With Advanced Cancer

  Pain, a debilitating consequence of cancer and its treatments, is highly prevalent among patients with advanced cancer.1 Often persistent and undertreated, it is associated with poor functional and emotional well-being and typically occurs along with insomnia and fatigue.2 The use of opioids,...

Breast Cancer
Supportive Care
Symptom Management
Pain Management

Effect of Exercise on Symptom Burden and Quality of Life in Patients With Metastatic Breast Cancer

Taking part in an exercise program may improve pain, fatigue, and quality of life in patients with metastatic breast cancer, according to recent findings presented by Hiensch et al at the 2024 European Breast Cancer Conference (EBCC; Abstract 1). Background “Although there’s been quite a lot of...

Pain Management

SBRT vs Conventional External-Beam Radiotherapy for Painful Bone Metastases

In a systematic review and meta-analysis reported in JAMA Network Open, Bindels et al found no difference in overall pain response rates between stereotactic body radiotherapy (SBRT) and conventional external-beam radiotherapy (cEBRT) in terms of relief of pain for patients with painful bone...

Breast Cancer
Pain Management
Symptom Management

Hyperbaric Oxygen Therapy for Late Local Toxic Effects in Patients Receiving Adjuvant Radiotherapy for Breast Cancer

In a Dutch study (HONEY) reported in JAMA Oncology, van der Molen et al found that patients with breast cancer and late local toxic effects after adjuvant radiotherapy who completed hyperbaric oxygen therapy (HBOT) had reductions in pain and fibrosis. However, only a minority of patients offered...

Survivorship
Pain Management

Can Physical Activity Lessen Pain Intensity in Cancer Survivors?

Physical activity may help lessen the intensity of pain in cancer survivors, according to a recent study published by Swain et al in Cancer. Background Current U.S. guidelines regarding physical activity recommend that individuals receive 150 to 300 minutes of moderate-intensity exercise per week,...

Issues in Oncology
Pain Management

New Findings Challenge Widely Accepted Beliefs About the Relative Efficacy of Opioids in Treating Cancer Pain

Investigators have uncovered concerningly large gaps in evidence regarding the true benefits of opioids for pain relief in patients with cancer, according to a novel study published by Shaheed et al in CA: A Cancer Journal for Clinicians. The new findings could challenge the commonly held view that ...

Supportive Care
Pain Management
Palliative Care
Symptom Management

Using Recent Diagnostic Scans May Cut Time to Treatment for Patients Needing Urgent Palliative Radiotherapy

Using previously taken diagnostic computed tomography (CT) scans in place of CT simulation scans to plan simple palliative radiation treatments may substantially reduce the time spent waiting for urgent treatment, improving the patient experience, a new study suggests. Patients who may benefit from ...

Issues in Oncology
Pain Management

Impact of Changing Opioid Prescription Landscape for Patients With Cancer

Despite the common use of opioids in clinical settings, new and persistent opioid prescriptions have declined among patients both with and without cancer, according to new findings presented by Baum et al at the 2023 ASCO Annual Meeting (Abstract 1592). However, the declines in opioid use among...

Issues in Oncology
Pain Management

ED Visits Among Patients With Cancer: Three Main Messages

There are “three main messages” to be gleaned from a study about emergency department visits and unplanned hospitalizations among patients with cancer, the study’s lead author, Amir Alishahi Tabriz, MD, PhD, MPH, told The ASCO Post. Dr. Alishahi is Assistant Member, Department of Health Outcomes...

Issues in Oncology
Pain Management

Study Finds Cancer-Related Emergency Department Visits Increased by 67%, Mainly Because of Uncontrolled Pain

Emergency department (ED) visits by patients with cancer increased by 67.1% between the start of 2012 and the end of 2019, compared with an increase of just 7.5% in cancer incidence, according to a recent study in JAMA Network Open.1 Factors identified as possible explanations for the...

Supportive Care
Pain Management

Pain Control for Localized Spine Metastases: Stereotactic Radiosurgery vs Conventional Radiotherapy

As reported in JAMA Oncology by Ryu et al, the phase III portion of the NRG Oncology/RTOG 0631 trial showed no benefit in pain relief with use of stereotactic radiosurgery (SRS) vs conventional external-beam radiotherapy (EBRT) in patients with one to three sites of vertebral metastases. Study...

Geriatric Oncology
Pain Management

Older Minority Patients With Cancer Face Inequities in Opioid Access Near the End of Life

Research shows that pain is a common byproduct of cancer and its treatment, with approximately 55% of patients undergoing active treatment experiencing pain, and more than 66% of patients with advanced disease experiencing pain. According to the ASCO guideline on the use of opioids for adults with...

Pain Management

Integrative Approaches to Managing Pain in Patients With Cancer: SIO-ASCO Guideline

Pain is highly prevalent in people with cancer throughout the disease trajectory. Often persisting for years after initial diagnosis and undertreated, it is associated with poor functional, mental, and cancer-related outcomes.1 Consequently, the need for effective pain management strategies has...

Supportive Care
Pain Management

Prophylactic Radiation for Asymptomatic Bone Metastases May Reduce Pain and Extend Survival

Treating high-risk, asymptomatic bone metastases with radiation may reduce painful complications and hospitalizations and possibly extend overall survival in people whose cancer has spread to multiple sites, a phase II clinical trial suggests. Results of the multicenter, randomized trial were...

Pain Management

Impact of CDC Opioid-Prescribing Guideline on Prescriptions and Potential Misuse/Substance Use Disorder Among Childhood Cancer Survivors

In a study reported in JAMA Oncology, Hu et al found decreases in the rates of opiate prescription and potential misuse/substance use disorders among survivors of childhood cancer following the March 2016 release of the Centers for Disease Control and Prevention (CDC) opioid-prescribing guideline....

Lung Cancer
Pain Management

New, Long-Term Opioid Use After Lung Cancer Surgery Linked to Reduced 2-Year Survival

New, long-term use of opioids after lung cancer surgery was linked to a 40% increased risk of death from any cause within the following 2 years, according to findings published by Oh et al in the journal Regional Anesthesia & Pain Medicine. Persistent postoperative pain has been reported in up...

Supportive Care
Pain Management

New Consensus-Based Guidance on Managing Cancer Pain in Patients With Opioid Use Disorder or Opioid Misuse

Opioids are a cornerstone of cancer pain management, but there is a lack of consensus on how to treat pain patients with cancer who also have struggled with opioid use disorder or prescription opioid misuse. In a study published by Fitzgerald Jones et al in JAMA Oncology, researchers outlined...

Head and Neck Cancer
Pain Management

Gabapentin May Be an Effective Alternative to Opioids for Patients With Head and Neck Cancer Receiving Radiation

Patients with head and neck cancer undergoing radiation therapy may be less likely to require opioids or a feeding tube if they received a higher dose of prophylactic gabapentin before their treatment, findings from a team of radiation oncologists showed. Their report, published by Ma et al in JAMA ...

Pain Management

Massage for Pain Management in the Cancer Population

Guest Editor’s Note: Pain is a debilitating symptom experienced by many patients with cancer that negatively impacts their quality of life. Massage therapy, historically used for relaxation and pain relief, plays an important supportive role in oncology settings. In this installment of The ASCO...

Pain Management

Studies Show That Laws to Limit Opioid Prescribing Have Hampered Pain Control for Patients With Cancer

In 2015, an unprecedented phenomenon occurred in the United States: according to the World Bank Group, the nation’s average life expectancy fell from 78.8 years in 2014 to 78.7 years in 2015, then to 78.5 years in 2017. The last time our life expectancy registered a similar decline was in the years ...

Pain Management

The High Price of Pain

According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2019, nearly 247,000 people died from overdoses involving prescription opioids in the United States. According to the CDC, the problem can be broken into three waves. The first began with an increase in prescribing...

Pain Management

Study Finds Evidence-Based Interventions Added to Screening Did Not Improve Cancer Pain

When added to regular screening and guidelines, evidence-based interventions implemented at the patient, health professional, and service levels did not significantly improve cancer pain, according to research led by Melanie Lovell, MBBS, PhD, Medical Head of Palliative Care at HammondCare and...

Supportive Care
Pain Management

Early-Phase Study Rediscovers Potential Alternative to Methadone for Cancer Pain

Levorphanol was associated with improved pain and symptom control in patients with advanced cancer, according to data from an early phase I trial, reported by Akhila Reddy, MD, at the 2021 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO)...

Survivorship
Pain Management

Does Pain Affect the Employment and Financial Outcomes of Cancer Survivors?

In a study reported in the Journal of Clinical Oncology, Halpern et al found that cancer survivors with pain had worse employment and financial outcomes than did those reporting no pain. Study Details The study used data from 1,213 adult survivors identified from the 2016–2017 Medical Expenditure...

Palliative Care
Pain Management

Trends in Opioid Prescriptions Among Patients With Cancer Near the End of Life

In a study reported in the Journal of Clinical Oncology, Enzinger et al found that the prescription of opioids for cancer pain dropped markedly in the recent past among patients with poor-prognosis disease near the end of life, with the frequency of pain-related emergency department visits...

Pain Management
Supportive Care

Stereotactic Body Radiotherapy vs Conventional External-Beam Radiotherapy for Pain Control of Spinal Metastases

In a Canadian/Australian phase II/III trial reported in The Lancet Oncology, Arjun Sahgal, MD, and colleagues found that stereotactic body radiotherapy (SBRT) produced a higher complete pain response rate vs conventional external-beam radiotherapy (EBRT) in patients with painful spinal metastases. ...

Pain Management
Issues in Oncology

Results of a Restrictive Opioid Prescription Protocol for Patients With Cancer Undergoing Surgery

Seeing an opportunity to safely reduce the number of opioid doses prescribed to patients with cancer, researchers proposed a new pain management guideline for all patients undergoing surgery at Roswell Park Comprehensive Cancer Center. The results from the first 6 months of that effort, reported by ...

Breast Cancer
Symptom Management
Pain Management

Study Examines Aromatase Inhibitor–Associated Musculoskeletal Symptoms in a Diverse Population With Early Breast Cancer

A clinical trial in a racially diverse group of postmenopausal women with early breast cancer to study severe pain in the bones, muscles, ligaments, tendons, and nerves caused by aromatase inhibitor treatment has found that the symptoms were more commonly reported in Black and Asian patients than...

Pain Management
Supportive Care
Issues in Oncology

Oncologists’ Views on Challenges in Opioid Prescribing for Patients With Cancer-Related Pain

In an interview study reported in JCO Oncology Practice, Yael Schenker, MD, MAS, and colleagues identified challenges and measures for improvement cited by oncologists in the safe and effective prescribing of opioids for their patients with cancer-related pain. Study Details The investigators...

Integrative Oncology
Pain Management
Survivorship

Electroacupuncture and Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain in Cancer Survivors

In the PEACE study, reported in JAMA Oncology, Jun J. Mao, MD, MSCE, and colleagues found that both electroacupuncture and auricular acupuncture significantly reduced pain severity vs usual care in cancer survivors with chronic musculoskeletal pain. Noninferiority of auricular acupuncture to...

gynecologic cancers
pain management

Brittany A. Davidson, MD, on a Model to Predict the Need for Opioids After Gynecologic Surgery

Brittany A. Davidson, MD, of Duke University, discusses the development and validation of the GO-POP model (Gynecologic Oncology Predictor of Postoperative opioid use), an individualized patient-centered predictive tool designed to help avoid overprescribing pain medications (ID# 10253).

Breast Cancer
Pain Management

New Study Examines Patterns of Opioid Use Among Patients With Metastatic Breast Cancer

Some patients with metastatic breast cancer are taking smaller doses of opioid prescriptions over decreased amounts of time, according to results published by Shen et al in Scientific Reports. Researchers said that the results indicate that clinicians may be more aware of the negative impacts of...

Breast Cancer
Pain Management
Issues in Oncology

SABCS 2020: Opioid and Sedative-Hypnotic Use After Mastectomy With Reconstructive Surgery

Women who undergo mastectomy with reconstructive surgery as part of breast cancer treatment may face the risk of persistent use of opioids and sedative-hypnotic drugs, according to data presented by Jacob Cogan, MD, and colleagues at the 2020 San Antonio Breast Cancer Symposium (Abstract GS3-08)....

Pain Management

Management of Painful Spinal Metastases: SBRT vs Conventional Radiotherapy

Stereotactic body radiation therapy (SBRT) was superior to conventional radiation therapy in reducing pain from spinal metastases in a phase II/III study reported at the virtual edition of the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting.1 More than twice as many patients...

Supportive Care
Pain Management
Palliative Care

SBRT May Provide Superior Pain Relief From Spinal Metastases vs Conventional Radiotherapy

Stereotactic body radiation therapy (SBRT) was superior to conventional radiation therapy in reducing pain from spinal metastases in a phase II/III study reported by Arjun Sahgal, MD, and colleagues at the 2020 American Society for Radiation Oncology (ASTRO) Annual Meeting (Abstract LBA 2). More...

supportive care
pain management

Arjun Sahgal, MD, on Reducing the Pain of Spinal Metastases: SBRT vs Palliative Radiotherapy

Arjun Sahgal, MD, of the Sunnybrook Health Sciences Centre, discusses results of the first phase III trial to suggest that dose escalation with stereotactic body radiotherapy may be superior to conventional palliative radiotherapy in improving pain outcomes for patients with spinal bone metastases (Abstract LBA2).

issues in oncology
pain management

James D. Murphy, MD, on Opioid Use Among Patients With Cancer

James D. Murphy, MD, of the University of California, San Diego, discusses the possible reasons for a decline in long-term opioid use in patients with cancer, even as short-term use is rising, as well as the racial and socioeconomic disparities of opioid use in this population (Abstract 187).

Head and Neck Cancer
Pain Management

Oral Cancer Pain May Predict Likelihood of Metastasis

Oral cancer may be more likely to spread in patients experiencing high levels of pain, according to a team of researchers who found genetic and cellular clues as to why metastatic oral cancers are so painful. These findings were published by Bhattacharya et al in Scientific Reports. Researchers...

Pain Management
Palliative Care
Issues in Oncology

How Anxiety, Depression, and Low Social Support Impact the Intensity of Cancer Pain

Pain is one of the most common byproducts of cancer and its treatment. Tumors, surgery, intravenous chemotherapy, radiation therapy, targeted therapy, supportive care therapies (such as bisphosphonates), and diagnostic procedures can all cause pain in patients and may contribute to symptoms of...

Breast Cancer
Pain Management

Eliminating Routine Opioids While Maintaining Pain Control for Women Undergoing Lumpectomy or Excisional Biopsy

Changing from routinely prescribing opioids for patients who were having a lumpectomy or excisional biopsy to instead routinely prescribing nonsteroidal anti-inflammatory drugs [NSAIDs] resulted in a sharply decreased opioid prescription rate with “no difference in the proportion of patients...

Pain Management

Understanding the Underlying Mechanisms of Pain in Patients With Cancer

Pain is among the most difficult medical issues for oncologists to confront, said Tony L. Yaksh, PhD, Professor of Anesthesiology and Pharmacology at the University of California, San Diego, during his keynote address at the 2019 Supportive Care in Oncology Symposium. Failure to adequately manage...

Integrative Oncology
Symptom Management
Pain Management

Highlights From Complementary and Integrative Medicine Research and Implications for Clinical Practice

Due to COVID-19, this year’s ASCO Annual Meeting was convened using a virtual format. It was multidisciplinary, featuring more than 250 oral and 2,500 poster presentations from around the world in 24 disease-based and specialty tracks. Among the exciting talks in the session on symptoms and...

Issues in Oncology
Pain Management

Opioid-Related Deaths in the Cancer Population vs the General Population

In a study reported in a research letter in JAMA Oncology, Fumiko Chino, MD, and colleagues found that while the incidence of opioid-related death has increased in both the general population and in patients with cancer in recent years, opioid-related death is far less common among individuals with ...

Pain Management

Joint Publication Focuses on Clinical Practice Guidelines on Opioid Use for Pain Management

A recently published article by Schatz et al offers new clarity around the use of prescription opioids in pain management for people with a diagnosis or history of cancer and chronic pain. The joint publication, which appeared in both JNCCN—Journal of the National Comprehensive Cancer Network and...

head and neck cancer
pain management

Gopal K. Bajaj, MD, MBA, on Reducing Opioid Use in Patients With Head and Neck Cancer Undergoing Radiotherapy

Gopal K. Bajaj, MD, MBA, of the Inova Schar Cancer Institute, discusses the results of a small study that showed prophylactic gabapentin can be safely and effectively used to significantly reduce pain and the use of opioids in patients undergoing radiotherapy or chemoradiotherapy for head and neck squamous cell carcinoma.

prostate cancer
symptom management
pain management

Hannah L. Rush, MBChB, on Prostate Cancer: Comparing Quality of Life in Patients Receiving Docetaxel or Abiraterone

Hannah L. Rush, MBChB, of the Clinical Trials Unit at University College London, discusses an analysis of the STAMPEDE trial, which showed that patients treated with abiraterone had higher scores in global quality of life as well as in the physical, social, and role function domains and lower scores for pain and fatigue over the first 2 years than those receiving docetaxel (Abstract 14).

Head and Neck Cancer
Pain Management

Gabapentin and Methadone for Patients Undergoing Treatment of Head and Neck Cancer

With nearly all patients who undergo treatment for cancer of the head and neck experiencing oral mucositis, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients—while also reducing the need for opioid painkillers—a team...

Pain Management

Multidimensional Palliative Care: Fewer Opioids, More Pain Control in Patients With Advanced Cancer

For opioid-tolerant patients with advanced cancer experiencing pain, relief does not necessarily have to come from a higher dose of opioids, according to findings presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a retrospective analysis of 300 patients with advanced...

Supportive Care
Pain Management

Assessing Cancer Pain Management in the Era of the Opioid Epidemic

A vast majority of patients with cancer receiving opioids for the management of pain will adhere to the opioids as prescribed and will have no major difficulties with dose reduction and even treatment discontinuation if the pain syndrome resolves. However, about 20% of patients with cancer are at...

Supportive Care
Pain Management

Expert Point of View: Richard T. Lee, MD

Richard T. Lee, MD, Associate Professor at Case Comprehensive Cancer Center and University Hospitals Seidman Cancer Center, discussed the abstract by Galloway et al at the 2019 Supportive Care in Oncology Symposium. He remarked that starting a new palliative care consultation can sometimes feel...

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