title: A descriptive cross-sectional study of pain in patients with neuroendocrine tumors.
abstract: OBJECTIVE
  Neuroendocrine tumors (NET) are rare cancer forms, which are often disseminated at diagnosis. In cancer patients, pain is a feared symptom and reported in 30% of patients during treatment and in 70-90% with advanced disease. However, the extent and the severity of pain in patients with NET have never been investigated.
  
  
  METHODS
  We conducted a cross-sectional survey of 207 NET patients in the period March 2014 to March 2015 at our tertiary NET Center. We used a questionnaire to investigate the prevalence, severity and character of pain along with demographic, clinical and pathological data from medical records.
  
  
  RESULTS
  One hundred and 37 patients had undergone surgery (66%) of which 95 patients (69%) were considered cured and 112 patients had residual disease after surgery or comorbidity at diagnosis that contradicted surgery. Eighty-five patients (41%) reported any pain within the past week; the median pain intensity (numerical rating scale 0-10) was 5.0. Forty-seven (23%) of all included patients reported pain within the past week that developed in relation to NET or its treatment and 51% of these had pain descriptors consistent with neuropathic pain. The median level of plasma chromogranin A in patients with pain was significantly higher compared to patients without pain (p < .05).
  
  
  CONCLUSIONS
  A considerable proportion of our NET patients suffered from pain with moderate intensity and did not receive adequate pain treatment. Screening for pain should therefore be performed during NET follow-up visits and specific pain treatment should be considered.
authors.affiliation: a Department of Hepatology and Gastroenterology , Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Marie
authors.initials: M
authors.lastname: Madsen
authors.affiliation: a Department of Hepatology and Gastroenterology , Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Henning
authors.initials: H
authors.lastname: Grønbæk
authors.affiliation: b Danish Pain Research Center, Department of Clinical Medicine , Aarhus University , Aarhus , Denmark.
authors.forename: Nanna Brix
authors.initials: NB
authors.lastname: Finnerup
authors.affiliation: a Department of Hepatology and Gastroenterology , Aarhus University Hospital ENETS Centre of Excellence, Aarhus University Hospital , Aarhus , Denmark.
authors.forename: Gitte
authors.initials: G
authors.lastname: Dam
mesh_terms: D000368:Aged; D053379:Chromogranin A / Q000097:blood; D003430:Cross-Sectional Studies; D003718:Denmark; D005260:Female; D006801:Humans; D019394:Ki-67 Antigen / Q000032:analysis; D008297:Male; D008875:Middle Aged; D018358:Neuroendocrine Tumors / Q000473:pathology / Q000503:physiopathology* / Q000601:surgery; D010146:Pain / Q000453:epidemiology* / Q000209:etiology; D059408:Pain Management / Q000379:methods*; D010147:Pain Measurement; D011795:Surveys and Questionnaires
chemical_list: D053379:Chromogranin A; D019394:Ki-67 Antigen
keywords: Cancer; Ki-67; chromogranin-A; neuroendocrine tumor; pain