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Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology
Jean Potter1, Irene J Higginson
1Department of Palliative Care and Policy, GKT School of Medicine, King's College London, Weston Education Centre, Cutcombe Road, London SE5 9RJ, UK. jean.potter@kcl.ac.uk
Background:
Lung cancer is one of the commonest cancers to cause pain, but little is known regarding the extent of this complex problem in these patients.
Methods:
Medline (1966-June 2002) and Cancerlit (1975-May 2002) were searched to identify studies of lung cancer patients' experience of pain, its prevalence, causes and underlying pathophysiology.
Results:
Thirty-two studies were identified. Patients were recruited from diverse populations, and the prevalence varied according to study setting. Pain affected 27% of outpatients (range 8-85%), and 76% of patients cared for by palliative care services (range 63-88%). Pain was caused by cancer in 73% (range 44-87%), and cancer treatment in 11% (range 5-17%). Nociceptive pain was the major pathophysiological subtype in lung cancer pain, but neuropathic pain accounted for 30% (range 25-32%) of cases.
Conclusions:
The overall weighted mean pain prevalence of pain was 47% (range 6-100%). Cancer patients should be asked about pain at all stages of management. Those with pain should be investigated for disease progression and considered for referral for specialist management.
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