Pain Treatment and Cancer Patients: Are we Heeding Quality of Life?

Abstract

The use of opioid analgesics remains the primary therapy for pain control in cancer patients. However, ample evidence persists showing that treatment is still inadequate. This cross-sectional study was carried out during one year in a Brazilian Cancer Hospital to evaluate the impact of opioid use on analgesia and patients’ quality of life. The Pain Management Index (PMI), EORTC QLQ.C30 (Quality of Life of Cancer Patients), Karnofsky Performance Status (KPS), Douleur Neuropathique 4 (DN4), and Brief Pain Inventory-Short Form (BPI-SF) were used. A hundred patients with advanced solid tumors and using opioids were included, with 82% of them reporting daily pain with 58% having intense pain. Morphine with a mean dose of 49 Morphine Milligram Equivalent were used by 57% of them, and PMI was negative in 34% of the sample. Neuropathic pain was found in 72% of patients. The pain was related to all BPI variables. Despite the substantial negative impact of pain on QOL, no association was found between the clinical factors assessed and QOL itself. This gap can be related to the persistence of high levels of sub-treatment, depression, and neuropathic pain associated with the use of low doses of opiates and adjuvant medications in the sample.

Keywords:

• Cancer
• end of life
• pain
• quality of life
• symptoms

Compliance with ethical standards

All procedures performed in this study followed the institutional and national research committee’s ethical standards and the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

• Institutional Review Board previously approved this project.

• Informed consent was obtained from all individual participants included in the study.

Consent to participate

Informed consent form was signed by all participants.

Consent for publication

All authors read and approved this manuscript for publication.

Data availability statement

All data generated or analyzed during this study are included in this manuscript.

Declaration of interest

The author reports no conflict of interest. The author alone is responsible for the content and writing of the article.

Ethics approval

The project was approved by the Institutional Research Ethics Committee.

Funding

The author(s) reported there is no funding associated with the work featured in this article.