title: Neuropathic cancer pain: prevalence, severity, analgesics and impact from the European Palliative Care Research Collaborative-Computerised Symptom Assessment study.
abstract: BACKGROUND
  Neuropathic pain causes greater pain intensity and worse quality of life than nociceptive pain. There are no published data that confirm this in the cancer population.
  
  
  OBJECTIVE
  We hypothesised that patients with neuropathic cancer pain had more intense pain, experienced greater suffering and were treated with more analgesics than those with nociceptive cancer pain, and a neuropathic pain screening tool, painDETECT, would perform as well in those with cancer pain as is reported in those with non-cancer pain.
  
  
  METHODS
  The data were obtained from an international cross-sectional observational study.
  
  
  METHODS
  A total of 1051 patients from inpatients and outpatients, with incurable cancer completed a computerised assessment on symptoms, function and quality of life. In all, 17 centres within eight countries participated. Medical data were recorded by physicians. Pain type was a clinical diagnosis recorded on the Edmonton Classification System for Cancer Pain.
  
  
  RESULTS
  Of the patients, 670 had pain: 534 with nociceptive pain, 113 with neuropathic pain and 23 were unclassified. Patients with neuropathic cancer pain were significantly more likely to be receiving oncological treatment, strong opioids and adjuvant analgesia and have a reduced performance status. They reported worse physical, cognitive and social function. Sensitivity and specificity of painDETECT for identifying neuropathic cancer pain was less accurate than when used in non-cancer populations.
  
  
  CONCLUSIONS
  Neuropathic cancer pain is associated with a negative impact on daily living and greater analgesic requirements than nociceptive cancer pain. Validated assessment methods are needed to enable early identification of neuropathic cancer pain, leading to more appropriate treatment and reduced burden on patients.
authors.affiliation: Academic Unit of Palliative Care, St Gemma's Hospice, Leeds, UK. clareruddock@hotmail.com
authors.forename: Clare
authors.initials: C
authors.lastname: Rayment
authors.forename: Marianne J
authors.initials: MJ
authors.lastname: Hjermstad
authors.forename: Nina
authors.initials: N
authors.lastname: Aass
authors.forename: Stein
authors.initials: S
authors.lastname: Kaasa
authors.forename: Augusto
authors.initials: A
authors.lastname: Caraceni
authors.forename: Florian
authors.initials: F
authors.lastname: Strasser
authors.forename: Ellen
authors.initials: E
authors.lastname: Heitzer
authors.forename: Robin
authors.initials: R
authors.lastname: Fainsinger
authors.forename: Michael I
authors.initials: MI
authors.lastname: Bennett
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008017:Life Expectancy; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009369:Neoplasms / Q000150:complications* / Q000188:drug therapy; D009437:Neuralgia / Q000188:drug therapy* / Q000453:epidemiology / Q000209:etiology / Q000473:pathology; D010147:Pain Measurement / Q000379:methods*; D015995:Prevalence; D011788:Quality of Life; D063189:Symptom Assessment; D055815:Young Adult
chemical_list: D000700:Analgesics