Cancer is a growing problem. In the Netherlands, the twenty years prevalence of cancer
is rising during the years. In 1990, 223 540 persons were living with cancer (twenty years
prevalence). In 2002, the twenty years prevalence was 386 361 persons, and in 2010
540 371 persons. The prevalence of cancer increased with 3% – 3.5% per year since 1990.
This increase was mainly provoked by an increase in the national population, especially
elderly.
In cancer patients, pain is one of the most frequent and feared symptoms. Pain can
interfere with all aspects of daily life and pain relief is an important component of patients’
quality of life. The prevalence of cancer-related pain remained stable over the
years, although the knowledge on pain treatment did improve. For cancer patients with
all disease stages, the studies before 1990 showed that the prevalence of cancer-related
pain varied between 41% - 72%4-5, of whom 35% scored their pain as moderate to severe
(pain intensity score ≥ 5). The studies between 1990 and 2005 showed a prevalence
between 28% - 87%, of whom between 23% - 65% scored their pain as moderate to
severe, and studies after 2005 reported a prevalence of 52% - 72%, of whom between
20% - 56% scored their pain as moderate to severe. The prevalence of pain in cancer
patients is related to the stage of cancer. The review of Van den Beuken et al. showed
that the prevalence of cancer-related pain was 33% (95% Confi dence Interval (CI)
21-46%) in cancer patients after curative treatment (n=726); 59% (95% CI 44-73%) in
patients during anti-cancer treatment (n=1408); and 64% (95% CI 58-69%) in patients
with advanced disease (n=9763).
Cancer-related pain can be caused by (a) the direct growth and penetrat
