Simone Charles B, Vapiwala Neha, Hampshire Margaret K, Metz James M
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Opioid Manag. 2012 Jan-Feb;8(1):9-16. doi: 10.5055/jom.2012.0091.
Little data exist on assessing pain medication utilization among lung cancer patients or on the reasons they fail to receive optimal analgesic treatment. This study evaluates those reasons and investigates perceived causes of pain among individuals with lung cancer.
An institutional review board-approved Internet-based questionnaire was posted on http://www.oncolink.org that included 22 queries evaluating analgesic utilization, pain control, and attitudes regarding analgesics.
Between November 2005 and July 2008, 90 respondents with lung malignancies participated. Respondents were Caucasian (89 percent), male (54 percent), and had non-small-cell lung cancer (79 percent), small-cell lung cancer (12 percent), or mesothelioma (9 percent).
Respondents underwent surgery (48 percent), chemotherapy (58 percent), and radiotherapy (44 percent). Most respondents (92 percent) reported experiencing pain, with 52 percent attributing pain directly to cancer, 38 percent to cancer treatment, and 67 percent unsure of the primary cause. Among respondents experiencing pain, 33 percent did not use analgesics. Analgesic utilization was less in men (p = 0.050) but did not differ by minority status (p = 0.127), education level (p = 0.37), or lung cancer histology (p = 0.134). Analgesic use was higher in subjects receiving radiotherapy (p = 0.002) and chemotherapy (p = 0.013) but not surgery (p = 0.16). Reasons for not taking analgesics included fear of addiction/dependence (76 percent), healthcare providers not recommending medications (71 percent), and inability to pay for analgesics (56 percent). Participants pursued physical therapy (76 percent) and other complementary modalities (24 percent) for pain control.
Many individuals with lung cancer perceive pain from both their disease and their cancer treatment. However, some study respondents did not use analgesics due to concerns of addiction, cost, or their healthcare providers not recommending analgesics. Medicalprofessionals providing medical management for lung cancer patients should make pain management a priority and regularly discuss pain symptoms and pain management with patients.
关于评估肺癌患者止痛药使用情况或其未能接受最佳镇痛治疗原因的数据较少。本研究评估这些原因，并调查肺癌患者疼痛的感知原因。
一份经机构审查委员会批准的基于互联网的问卷发布在http://www.oncolink.org上，其中包含22个问题，用于评估镇痛药物使用、疼痛控制以及对镇痛药的态度。
2005年11月至2008年7月期间，90名患有肺部恶性肿瘤的受访者参与了调查。受访者为白种人（89%），男性（54%），患有非小细胞肺癌（79%）、小细胞肺癌（12%）或间皮瘤（9%）。
受访者接受了手术（48%）、化疗（58%）和放疗（44%）。大多数受访者（92%）报告经历过疼痛，其中52%将疼痛直接归因于癌症，38%归因于癌症治疗，67%不确定主要原因。在经历疼痛的受访者中，33%未使用镇痛药。男性的镇痛药使用率较低（p = 0.050），但在少数族裔状况（p = 0.127）教育水平（p = 0.37）或肺癌组织学类型（p = 0.134）方面无差异。接受放疗（p = 0.……此处原文有误，应为0.002）和化疗（p = 0.013）的受试者镇痛药使用量较高，但接受手术的受试者（p = 0.16）并非如此。不服用镇痛药的原因包括害怕成瘾/依赖（76%）、医疗保健提供者未推荐药物（71%）以及无力支付镇痛药费用（56%）。参与者采用物理治疗（76%）和其他辅助方式（24%）来控制疼痛。
许多肺癌患者认为疾病和癌症治疗都会带来疼痛。然而，一些研究受访者因担心成瘾、费用或医疗保健提供者未推荐镇痛药而未使用镇痛药。为肺癌患者提供医疗管理的医疗专业人员应将疼痛管理作为优先事项，并定期与患者讨论疼痛症状和疼痛管理。
