thesis

To Be In Pain Or Not: research to improve cancer-related pain management

Abstract

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

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