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The challenges and opportunities for cancer pain management in primary and community care services: a scoping review.

Uncontrolled cancer pain remains one of the most common reasons for unscheduled medical care in the UK, yet primary and community care services often lack standardized approaches to management. This scoping review explored existing evidence on cancer pain management within primary and community care settings, focusing on integration strategies, barriers to access, and facilitators of equitable pain management, particularly in underserved populations. Six electronic databases were searched for studies published between 2000 and 2025. Thirty-two articles were included, encompassing systematic re…

Association Between Opioid Use and Sensory Perception in Patients with Cancer Pain: A Neurometric Study.

BACKGROUND: Opioids are a cornerstone of cancer pain management; however, their effects on sensory and pain thresholds in routine clinical settings remain incompletely understood. OBJECTIVE: To investigate the association between opioid use and neurometric sensory and pain thresholds in patients with cancer-related pain. METHODS: This cross-sectional observational study assessed quantitative sensory function using the Neurometer®. Current perception thresholds (CPT) and pain thresholds (PT) for Aβ, Aδ, and c fibers were evaluated in 208 adult patients with cancer pain in a hospital-based pal…

Five-Element Music and VR for Pain and Psychological Distress in Advanced Cancer: A Randomized Trial.

CONTEXT: Pain and psychological distress are common and debilitating symptoms in patients with advanced cancer. Non-pharmacological interventions such as Five-Element Music therapy and virtual reality (VR) have shown promise in improving symptom management, but their combined effects remain unclear. OBJECTIVES: This study aimed to evaluate the clinical effectiveness of the combination of Five-Element Music and VR in improving pain, anxiety, depression, and sleep quality in cancer patients, as well as its impact on serum β-endorphin (β-EP) and 5-hydroxytryptamine (5-HT) levels, providing an in

Treatment of neuropathic pain in cancer survivors: a scoping review of pharmacological, exercise, and psychosocial interventions.

Background and purposeNeuropathic pain is a debilitating late effect among cancer survivors. This scoping review aims to provide an overview of pharmacological, psychological, and exercise interventions for neuropathic pain among cancer survivors and to identify further relevant research areas. Patient/material and methods: PubMed, PsychInfo, and EMBASE were systematically searched for studies published from January 2004 to January 2026 and abstract and full text screening was carried out. The target population was cancer survivors who had completed primary treatment and have no active disease

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… Standards for the management of cancer-related pain across Europe-A position paper from the EFIC Task Force on Cancer Pain . … Gabapentin and an opioid combination versus opioid alone for the management of neuropathic cancer pain: a randomized open trial . …

Risk factors and development of a predictive nomogram model for acute postoperative pain in oral cancer.

This study aimed to determine the incidence and independent factors of acute postoperative pain in oral cancer patients and develop an individualized predictive nomogram. A retrospective cohort study included 458 oral cancer patients who underwent tumor resection with free flap reconstruction at Wuhan University’s Hospital of Stomatology (January 2023–December 2024). Demographics, medical history, tumor features, surgical variables, and preoperative anxiety/depression were collected. Pain intensity was assessed using the Numerical Rating Scale (NRS) on postoperative days 1, 2, 3, and 7. Indepe

Management of acute cancer-related pain in a patient with opioid use disorder: a case report.

BACKGROUND: Managing cancer-related pain in patients with opioid use disorder (OUD) poses significant challenges. We present this case of an OUD patient with severe intractable pain from metastatic testicular cancer to illustrate one approach to effective pain management. CASE PRESENTATION: A 31-year-old non-Hispanic White man with OUD experienced acute intractable cancer-related pain that was ultimately controlled with > 4700 daily oral morphine equivalents of patient-controlled fentanyl analgesia. He successfully weaned to oral methadone with oxycodone for breakthrough pain. CONCLUSIONS: E

Risk of cancer incidence and mortality in patients with chronic pain: A systematic review and meta-analysis.

Evidence from experimental studies suggests that pain may influence cancer development. We conducted a systematic review (registration osf.io/ms437) of the epidemiological studies assessing whether chronic pain, with minimal or non-inflammatory features, increases the risk of cancer incidence or mortality. The search used Scopus and Web of Science up to 11/03/2025. Quality assessment used the Newcastle-Ottawa Scale. Study characteristics and outcomes were analysed using narrative synthesis, with random-effects meta-analysis and meta-regression conducted where appropriate. A total of 23 studies

Knowledge and barriers to pain management among cancer caregivers in Malaysia: a cross-sectional study.

INTRODUCTION: Pain control among cancer patients remains inadequate despite the availability of effective pharmacological treatments. Caregi … patients (r = 0.08 (95% CI [0.04-0.13]), p ≤ 0.001) are the associated factors for barriers toward cancer pain management. CONCLUSION: The knowledge of pain management among family caregivers in our study was comparable to other previous studies. Level of knowledge, single status, pain experience, and monthly income had significant associations with barrier …

Percutaneous Cervical Cordotomy for Refractory Cancer Pain With General Anesthesia and Neuromonitoring: A Case Report.

BACKGROUND: Cancer-related pain remains one of the most debilitating symptoms in patients with advanced malignancy, with a significant propo … s approach may expand the applicability of cordotomy in carefully selected patients with refractory cancer pain, particularly when patient comfort is a priority.

Intranasal ketamine for chronic cancer-related pain in the outpatient setting: a double-edged sword.

INTRODUCTION: Of the 11.9 million Americans living with cancer, 44% experience cancer-related pain. High-dose opioids remain the mainstay of treatment but often reduce quality-of-life (QoL) due to side effect burden, and 40% of patients do not achieve adequate analgesia. Intranasal ketamine offers analgesia without the dose-limiting gastrointestinal or respiratory effects of opioids. It's intranasal formulation allows easier self-administration. This case series highlights the adverse effects of self-administered intranasal ketamine. OBJECTIVES: Describe the impact of self-administered intran

Bridging Gaps in Cancer Pain Care: Barriers, Solutions, and a Path Forward for Integrated Management.

Cancer-related pain remains one of the most frequent and burdensome symptoms in oncology, significantly impairing patients' quality of life … ian scientific societies involved in oncology and supportive care, to examine the current status of cancer pain management and develop a consensus on actionable priorities. Four key gaps were identified: insufficient education and training of healthcare providers in pain management; fragmented care pathways and limited interdisciplinary integration; lack of c …

Malignancy-Associated Renal Infarction: A Case of Prostate Cancer Presenting With Flank Pain and Hematuria.

Renal infarction is an uncommon but critical diagnosis that is frequently overlooked due to its nonspecific presentation and overlap with more common causes of abdominal or flank pain. Patients with malignancy, including metastatic prostate cancer, are at increased risk of thromboembolic events due to the intrinsic hypercoagulable state promoted by cancer, yet arterial events, such as renal infarction, remain underrecognized. We present the case of a 74-year-old male with metastatic castrate-sensitive prostate cancer who developed acute abdominal pain, nausea, and vomiting. Evaluation revealed

Clinical Outcomes of Methadone for Refractory Cancer Pain, Including Add-On Switching to Prior Opioids.

OBJECTIVES: Methadone has emerged as an effective treatment for refractory cancer pain. In Japan, guidelines recommend methadone for patients with cancer pain refractory to strong opioids, using methods like the stop-and-go(SAG)approaches. However, the optimal methadone-switching strategy remains unclear. METHODS: A retrospective analysis was conducted on 34 patients treated with methadone for refractory cancer pain. Methadone switching methods, efficacy, and adverse events were evaluated. RESULTS: Of the 32 evaluable cases, 18.7% underwent the SAG method, while 81.2% received the add-on met…

Multisite Chronic Pain and the Risk of Breast Cancer and Its Subtypes: A Mendelian Randomization Study.

BACKGROUND: Chronic pain (CP) is widespread and a major cause of disability. However, its genetic and environmental risk factors, as well as its relationship with breast cancer (BC), remain unclear. The study is the first to apply Mendelian randomization (MR) to explore the causal relationship between CP and BC. METHODS: Two-sample MR and multivariable MR (MVMR) were performed using genome-wide association study (GWAS) data. Univariable MR assessed the effect of CP on BC, while MVMR adjusted for body mass index (BMI). The inverse variance-weighted method was used as the primary method. RESUL

Prevalence of Pain and Associated Clinical Characteristics in 10-Year Survivors of Head and Neck Cancer.

OBJECTIVE: Pain prevalence in long-term head and neck cancer (HNC) survivors is important but understudied to date. The present investigation examined pain prevalence, associated clinical characteristics, and disease-specific health-related quality of life (HRQOL) in a cohort of survivors 10 years postdiagnosis (N = 187). STUDY DESIGN: Retrospective cohort study. SETTING: Single-institution tertiary care center. METHODS: Pain was assessed using a single-item numeric rating scale. Clinical characteristics were abstracted from the patient medical record and HNC-specific HRQOL scores were meas

Current Status of Cognition and Clinical Practice of Refractory Cancer Pain in Shanghai: A Questionnaire Survey.

PURPOSE: This study aimed to assess the current status of clinical practice of refractory cancer pain (RCP) among a sample of physicians specializing in cancer pain management in Shanghai. METHODS: From 2019 to 2021, a questionnaire survey was conducted among physicians engaged in diagnosis and treatment of cancer pain through the questionnaire WJX network platform in Shanghai, China. RESULTS: A total of 238 responses participated in the survey. This survey reports physicians' understanding and incidence rate of breakthrough cancer pain (BTCP). The choice of analgesics and satisfaction of an…

Recall of Psychotherapy Information and Immersiveness in a Virtual Reality Application for Cancer-Related Chronic Pain.

INTRODUCTION: There is increasing interest in the use of virtual reality (VR) as a modality to provide health interventions to patients. An unmet need in patients with cancer-related chronic pain is the availability of effective nondrug, pain psychology-based therapies that improve function and quality of life. To address this need, we previously created a custom-made VR program that teaches how to self-administer progressive muscle relaxation and guided pain visualization therapy in patients with cancer. We sought to determine if knowledge retrieval of these therapies is affected when compari

Botulinum Toxin for Pain Relief in Cancer Patients: A Systematic Review of Randomized Controlled Trials.

Cancer pain is one of the most disabling symptoms complained by cancer patients, with a crucial impact on physical and psychological well-being. Botulinum neurotoxins (BoNTs) type A and B have emerged as potential interventions for chronic pain; however, their role in these patients is still debated. Thus, this systematic review of randomized controlled trials aimed at assessing the effects of BoNT treatment for cancer pain to guide physicians in an evidence-based approach integrating BoNT in cancer care. Out of 5824 records, 10 RCTs satisfied our eligibility criteria and were included in the …

Managing acute pain with inhaled methoxyflurane in non-cancer patients: a review of the latest evidence.

PURPOSE OF THE REVIEW: Penthrox® (inhaled methoxyflurane, IMF) is an inhaled analgesic used for the treatment of moderate-to-severe acute pain. It has various advantages including the capacity for being self-administered in the presence of healthcare providers (HCPs), rapid onset and offset, and having documented evidence for minimal adverse events post-use. In a variety of non-oncological settings such as pre-hospital transport and minor outpatient procedures, amongst others, IMF has significantly reduced acute pain. As IMF has the capacity to provide appreciable pain relief but is not as wid