Haumann Johan, Joosten E Bert A, Everdingen Marieke H J van den Beuken-van
aUniversity Pain Centre Maastricht (UPCM), Department of Anesthesiology and Pain Management, Maastricht University Medical Centre, Maastricht bDepartment of Anaesthesiology and Pain Management, OLVG, Amsterdam cDepartment of Translational Neuroscience, school of Mental Health and Neuroscience, Maastricht University dCentre of Expertise for Palliative Care, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands.
Curr Opin Support Palliat Care. 2017 Jun;11(2):99-104. doi: 10.1097/SPC.0000000000000261.
Cancer incidence increases worldwide and thus more patients will suffer from cancer pain. As cancer pain severely affects quality of life, the decrease of pain should be of high priority for every clinician. In the last decade, attention for cancer pain and for its treatment has increased, and new pharmacological based treatment options became available. This gave reason to hypothesize a decrease in pain prevalence in cancer patients over the last decade.
Despite increased attention to cancer pain, pain prevalence in cancer patients has not significantly changed over the last decade as compared to the four decades before. This absence of change might be because of comorbidities cancer patients have, but also to undertreatment of pain, because of a lack of knowledge and pain measurement. Other factors underlying this absence of change are the use of incorrect coanalgesics in the case of treatment of neuropathic pain, as well as the present absence of potent analgesics with little side effects.
Consistent screening of pain in cancer patients and consequent correct treatment of pain might result in an impressive decrease in cancer pain. For further reduction of pain, new pharmacological analgesics need to be developed.
全球癌症发病率呈上升趋势,因此会有更多患者遭受癌痛折磨。由于癌痛严重影响生活质量,减轻疼痛应成为每位临床医生的首要任务。在过去十年中,对癌痛及其治疗的关注度有所提高,并且出现了新的基于药理学的治疗选择。这使得人们推测在过去十年中癌症患者的疼痛患病率有所下降。
尽管对癌痛的关注度有所提高,但与之前的四十年相比,癌症患者的疼痛患病率在过去十年中并未显著变化。这种无变化可能是由于癌症患者存在合并症,也可能是由于缺乏知识和疼痛测量导致疼痛治疗不足。导致这种无变化的其他因素包括在治疗神经性疼痛时使用了不正确的辅助镇痛药,以及目前缺乏副作用小的强效镇痛药。
对癌症患者进行持续的疼痛筛查并随之进行正确的疼痛治疗,可能会使癌痛显著减轻。为了进一步减轻疼痛,需要开发新的药理学镇痛药。