Mamiya Keiko, Iida Hiroki, Iseki Masako, Yamaguch Shigeki, Yonekura Hiroshi, Ueno Hiroshi, Kosugi Toshifumi, Sasara Takeshi, Takao Yumiko, Takasusuki Toshifumi, Hashiguchi Saori, Hirakawa Naomi, Sugiyama Yoko, Yamada Keiko, Yamamoto Kenji
Division of Palliative Medicine, Shinshu Cancer Center, Shinshu University Hospital, 3-1-1 Asahi, Matsumoto, 390-8621, Japan.
Gifu University/Anesthesiology and Pain Relief Center, Central Japan International Medical Center, Minokamo, Japan.
J Anesth. 2025 Apr;39(2):161-181. doi: 10.1007/s00540-024-03427-0. Epub 2024 Dec 4.
In September 2023, the Japan Society of Pain Clinicians (JSPC) issued this consensus statement on chronic pain treatment in cancer survivors. With recent advances in the early diagnosis and treatment of cancer, its prognosis has improved, so prolonged pain in cancer survivors is considered to represent chronic pain and should be addressed. In this statement, we emphasize that not all cancer survivor pain is cancer pain. Pain that is not cancer pain should be managed with analgesics other than opioids and nerve blocks, and pain that persists despite this approach should be treated as non-cancer chronic pain so as to prevent opioid overuse. In addition, cancer survivors at any stage of disease have a potentially life-threatening condition and constantly carry the fear of cancer recurrence. Therefore, even non-cancer pain should not be treated in the same way as general chronic pain, but should be managed with consideration of emotional distress. In the future, we plan to create educational tools for healthcare professionals and to conduct online seminars, both with the goal of providing cancer survivors with appropriate assessment and treatment of chronic pain.
2023年9月，日本疼痛临床医生协会（JSPC）发布了这份关于癌症幸存者慢性疼痛治疗的共识声明。随着癌症早期诊断和治疗的最新进展，其预后有所改善，因此癌症幸存者的长期疼痛被认为代表慢性疼痛，应予以处理。在本声明中，我们强调并非所有癌症幸存者的疼痛都是癌痛。非癌痛应使用阿片类药物和神经阻滞以外的镇痛药进行管理，尽管采用了这种方法仍持续存在的疼痛应作为非癌性慢性疼痛进行治疗，以防止阿片类药物过度使用。此外，处于疾病任何阶段的癌症幸存者都有潜在的危及生命的状况，并一直怀揣着癌症复发的恐惧。因此，即使是非癌性疼痛，也不应与一般慢性疼痛采用相同的治疗方式，而应在考虑情绪困扰的情况下进行管理。未来，我们计划为医疗保健专业人员创建教育工具并举办在线研讨会，两者的目标都是为癌症幸存者提供慢性疼痛的适当评估和治疗。
