A survey of pain in patients with advanced cancer

Journal of Pain and Symptom Management
R TwycrossS Bergl

Abstract

One hundred eleven patients with advanced cancer and pain newly referred to a palliative care center completed the Brief Pain Inventory (BPI) weekly for up to 4 weeks. The aims were (a) to review the numbers and causes of pain, (b) to consider the usefulness of the BPI in the evaluation of pain in cancer patients, and (c) to determine the impact of treatment. A total of 370 pains were recorded initially, a median of 3 per patient; 85% had more than 1 pain and more than 40% had 4 or more pains. Causes of pain were cancer (46%), debility (29%), treatment (5%), concurrent disorder (8%), and no stated cause (12%). The top 10 individual causes accounted for 73% of the pains. Seventy-six (68%) of the patients completed two BRIs, but only 46 (41%) completed 5. After 4 weeks, the median number of pains had fallen to 1.5; 78% still had more than 1 pain, but only 20% had 4 or more pains. Intensity of pain also declined, particularly in the first 2 weeks. With their last BPI, 23% had become completely pain free and a further 27% achieved acceptable relief (worst pain scores 1-4), compared with none and 24% initially. Of those who completed all five BPIs, the final respective figures were 22% and 29%. In contrast, 23% of patients still had...Continue Reading

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