Brief review: Pain management for cancer survivors: challenges and opportunities
- 6 May 2014
- journal article
- review article
- Published by Springer Science and Business Media LLC in Canadian Journal of Anesthesia/Journal canadien d'anesthésie
- Vol. 61 (8), 745-753
- https://doi.org/10.1007/s12630-014-0170-5
Abstract
As the number of cancer survivors continues to increase due to advances in medicine, many cancer survivors remain on their same pain management regimen long after their cancer treatment has been completed. Thus, the purpose of this review is to encourage awareness of the challenges and opportunities of pain management in cancer survivorship. It is our expectation that these patients will be referred to pain medicine specialists so their pain management can be optimized during the period of survivorship and ultimately improve their quality of life. Cancer and its treatment can cause significant pain which requires multidrug therapy, including strong analgesics such as opioids. Optimal pain management has been shown to improve the quality of life of cancer patients, and that is also true for cancer survivors. Nevertheless, the appropriate use of pain medications, especially opioids, must be re-evaluated and adjusted during treatment as the patient transitions into survivorship care and thereafter. This may otherwise result in unnecessary opioid use or may even lead to abuse. Fortunately, as cancer treatment is completed and the survivorship period begins, pain improves gradually and the need for pain medication should decrease. Unfortunately, some patients continue to take their potent analgesics during the period of survivorship although it may not be necessary. It is a challenge for pain practitioners who do not see these patients early in their disease or in the recovery period. Nevertheless, this challenge presents an opportunity for pain management providers to educate oncologists to refer cancer survivors to pain centres early during the period of their survivorship. Cancer survivors could then receive optimal care and maintain a better quality of life without having to take unnecessary pain medications. It is clear that there is a need to improve pain management in cancer patients, particularly in cancer survivors. Pain physicians should play a critical role as part of a multidisciplinary team that cares not only for cancer patients but also for cancer survivors. Optimizing pain management during the cancer survivorship period results in a better quality of life. Avec lâaugmentation du nombre de patients survivant Ă un cancer grĂące aux progrĂšs de la mĂ©decine, nombre dâentre eux conservent le mĂȘme protocole de gestion de la douleur longtemps aprĂšs la fin de leur traitement. Lâobjectif de cet exposĂ© Ă©tait donc dâencourager la sensibilisation aux dĂ©fis et opportunitĂ©s de la gestion de la douleur chez les survivants du cancer. Nous nous attendons Ă ce que ces patients soient adressĂ©s Ă des spĂ©cialistes du traitement de la douleur de façon Ă ce que la prise en charge de la douleur soit optimisĂ©e pendant la pĂ©riode de survie et, finalement, amĂ©liore leur qualitĂ© de vie. Le cancer et son traitement peuvent causer des douleurs significatives qui nĂ©cessitent une multithĂ©rapie incluant des analgĂ©siques puissants tels que les opioĂŻdes. Il a Ă©tĂ© montrĂ© que la gestion optimale de la douleur amĂ©liore la qualitĂ© de vie des patients cancĂ©reux, ce qui est Ă©galement vrai pour ceux qui ont survĂ©cu Ă un cancer. NĂ©anmoins, la bonne utilisation des mĂ©dicaments de la douleur, notamment des opioĂŻdes, doit ĂȘtre rĂ©Ă©valuĂ©e et adaptĂ©e au cours du traitement lorsque le patient entre dans la phase des soins de survie Ă la maladie et au-delĂ . Faute de quoi, une utilisation inadĂ©quate des opioĂŻdes pourrait mĂȘme dĂ©boucher sur des abus de ces mĂ©dicaments. Heureusement, avec la fin du traitement du cancer et le dĂ©but de la pĂ©riode de survie, la douleur sâamĂ©liore progressivement et le besoin de mĂ©dicaments contre la douleur devrait baisser. En revanche, certains patients continuent Ă prendre leurs analgĂ©siques puissants au cours de la pĂ©riode de survie bien que cela puisse ne pas ĂȘtre nĂ©cessaire. Câest un dĂ©fi pour les mĂ©decins de la douleur qui ne voient pas ces patients prĂ©cocement au cours de leur maladie ou pendant la phase de convalescence. NĂ©anmoins, pour les spĂ©cialistes du contrĂŽle de la douleur, ce dĂ©fi offre lâopportunitĂ© dâexpliquer aux oncologues quâils doivent adresser les patients survivant Ă des cancers Ă des centres de la douleur tĂŽt dans leur pĂ©riode de survie. Les patients survivant Ă un cancer pourraient alors recevoir des soins optimaux et maintenir une meilleure qualitĂ© de vie sans devoir prendre inutilement des mĂ©dicaments contre la douleur. Il existe un net besoin dâamĂ©liorer le contrĂŽle de la douleur chez les patients cancĂ©reux, en particulier chez les patients survivant au cancer. Les spĂ©cialistes de la douleur jouent un rĂŽle essentiel dans lâĂ©quipe multidisciplinaire qui traite non seulement les patients atteints de cancer, mais aussi ceux qui y survivent. Lâoptimisation du contrĂŽle de la douleur au cours de la pĂ©riode de survie au cancer aboutit Ă une meilleure qualitĂ© de vie.Keywords
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