APS Press Room
| For immediate release March 30, 2005 |
Contact: Chuck Weber (847) 705-1802 |
AMERICAN PAIN SOCIETY OFFERS NEW CLINICAL GUIDELINE PUBLICATIONS FOR TREATMENT OF CANCER PAIN
Separate Issues Now Available for Clinicians and Patients
BOSTON, March 30, 2005 – Despite advances in the field of pain management, studies still show that cancer pain is undertreated in most care settings. Today, the American Pain Society (APS) announced that its new, evidence-based clinical practice guideline is available in separate editions for clinicians and consumers to help them control and cope with the often intractable pain associated with the disease.
Every year some 1.2 million Americans are diagnosed with cancer and more than 500,000 die from it. Studies show pain is one of the problems patients with cancer fear the most.
“Undertreatment of cancer pain causes needless suffering, impairs patients’ ability to function, causes mood disturbances, hampers quality of life, and increases the burden on family caregivers,” said Christine Miaskowski, RN, PhD, professor and chair, department of physiological nursing, University of California – San Francisco and a co-chair of the APS cancer pain guideline panel.
“For clinicians, the new guideline provides evidenced-based recommendations to promote optimal assessment and management of cancer pain and improve the quality of care patients receive throughout the course of their disease and treatment,” added APS President Dennis Turk, Ph.D. “The consumer version summarizes the key findings of the clinical guideline in an easy-to-read format that should be a valuable educational tool for cancer patients and their families.”
The APS Guideline for the Management of Cancer Pain in Adults and Children was developed by an interdisciplinary panel of 13 prominent cancer pain experts who examined all relevant medical literature and scientific evidence to date. It updates and revises a previous cancer pain guideline written by the US Agency for Healthcare Research and Quality in 1994. Building on the AHRQ guideline, the APS publication offers some new directions for clinicians and other care providers by:
- Strongly emphasizing frequent pain assessments before and during treatment and on increasing family involvement in helping the patients manage their pain.
- Recommending that the most effective pain relief is accomplished through the anticipation and prevention of pain.
- Encouraging clinicians to educate and involve families of cancer pain patients in their pain management
- Relating that cognitive therapies, such as problem solving and guided imagery, and behavioral interventions, such as relaxation and controlled breathing, are integral components of effective multidisciplinary pain management programs that involve physicians, nurses, psychologists, social workers and others.
Miaskowski stressed that inadequate pain assessment is the single greatest barrier to effective cancer pain management; therefore, a key recommendation from the expert panel is that all cancer patients should be screened for pain at each outpatient visit or hospital admission, and the patient’s self-report should be used as the foundation for the pain assessment.
The APS guideline also recommends that a pain management plan should be developed for every patient based on pain assessments that include:
- a detailed history to determine the presence of persistent and breakthrough (sudden and severe) pain and its effects on function
- a psychosocial assessment
- a physical examination
- a diagnostic evaluation for signs and symptoms associated with common cancer pain presentations and syndromes.
Since most cancer patients have persistent or daily pain, Miaskowski explained that the APS guideline advises that it is important for them to use opioid-based pain medications, such as morphine, oxycodone and fentanyl, on a regular schedule rather than only “as needed.” Opioids normally are prescribed for treatment of moderate to severe cancer pain.
“Based on the ongoing reassessments of pain, opioid doses should be adjusted for each patient to achieve pain relief with an acceptable level of side effects,” Miaskowski said.
With regard to patient education, the APS guideline panel recommended that patients and families be given accurate and understandable information about the importance of effective cancer pain management, the use of analgesic medications, other methods of pain relief, and how to communicate effectively with clinicians about unrelieved cancer pain.
“Patient education should clarify myths and misconceptions and reassure patients and family caregivers that cancer pain can be effectively relieved and that addiction and tolerance are not problems associated with effective cancer pain management,” said Miaskowski.
The cancer publications are the third pain management clinical practice guideline developed by APS. It follows publication of The Guideline for the Management of Acute and Chronic Pain in Sickle-Cell Disease in 1999 and The Guideline for the Management of Osteoarthritis, Rheumatoid Arthritis and Juvenile Chronic Arthritis in 2002.