Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2021 Dec 6;17(1):34-45.
doi: 10.1515/med-2021-0393. eCollection 2022.

Current management of cancer pain in Italy: Expert opinion paper

Franco Marinangeli  1 , Annalisa Saetta  2 , Antonio Lugini  3
Affiliations
Review

Current management of cancer pain in Italy: Expert opinion paper

Franco Marinangeli et al. Open Med (Wars). .

Abstract

Introduction: Chronic pain and breakthrough cancer pain (BTcP) have a high prevalence in all cancer types and cancer stages, combined with a significant physical, psychological, and economic burden. Despite efforts to improve appropriate management of cancer pain, a poor assessment and guilty undertreatment are still reported in many countries. The purpose of this expert opinion paper is to contribute to reduce and clarify these issues with a multidisciplinary perspective in order to share virtuous paths of care.

Methods: Common questions about cancer pain assessment and treatment were submitted to a multidisciplinary pool of Italian clinicians and the results were subsequently discussed and compared with the findings of the published literature.

Conclusion: Despite a dedicated law in Italy and effective treatments available, a low percentage of specialists assess pain and BTcP, defining the intensity with validated tools. Moreover, in accordance with the findings of the literature in many countries, the undertreatment of cancer pain is still prevalent. A multidisciplinary approach, more training programs for clinicians, personalised therapy drug formulations, and virtuous care pathways will be essential to improve cancer pain management.

Keywords: breakthrough cancer pain; cancer pain; fentanyl; multidisciplinary team; rapid-onset opioids.

PubMed Disclaimer

Conflict of interest statement

Conflict of interest: The authors have no conflicts of interest to declare.

Figures

Figure 1
Figure 1
Davies algorithm [15].
Figure 2
Figure 2
Survey question: “In the management of cancer pain, which drug do you use mainly?.”
Figure 3
Figure 3
Survey question: “Which characteristic of a rapid onset opioid is the most important feature of your choice?.”
See this image and copyright information in PMC

References

    1. van den Beuken-van Everdingen MHJ, Hochstenbach LMJ, Joosten EAJ, Tjan-Heijnen VCG, Janssen DJA. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manag. 2016;51:1070–90. e910.1016/j.jpainsymman.2015.12.340. - DOI - PubMed
    2. van den Beuken-van Everdingen MHJ, Hochstenbach LMJ, Joosten EAJ, Tjan-Heijnen VCG, Janssen DJA. Update on prevalence of pain in patients with cancer: systematic review and meta-analysis. J Pain Symptom Manag. 2016;51:1070–90. doi: 10.1016/j.jpainsymman.2015.12.340. e9. - DOI - PubMed
    1. Bandieri E, Sichetti D, Luppi M, Di Biagio K, Ripamonti C, Tognoni G, et al. Is pain in patients with haematological malignancies under-recognised? The results from Italian ECAD-O survey. Leukemia Res. 2010;34:e334–5. 10.1016/j.leukres.2010.08.013. - DOI - PubMed
    2. Bandieri E, Sichetti D, Luppi M, Di Biagio K, Ripamonti C, Tognoni G. et al. Is pain in patients with haematological malignancies under-recognised? The results from Italian ECAD-O survey. Leukemia Res. 2010;34:e334–5. doi: 10.1016/j.leukres.2010.08.013. - DOI - PubMed
    1. Sutradhar R, Lokku A, Barbera L. Cancer survivorship and opioid prescribing rates: a population-based matched cohort study among individuals with and without a history of cancer. Cancer. 2017;123:4286–93. 10.1002/cncr.30839. - DOI - PubMed
    2. Sutradhar R, Lokku A, Barbera L. Cancer survivorship and opioid prescribing rates: a population-based matched cohort study among individuals with and without a history of cancer. Cancer. 2017;123:4286–93. doi: 10.1002/cncr.30839. - DOI - PubMed
    1. Boland EG, Ahmedzai SH. Persistent pain in cancer survivors. Curr OpSupportive Palliat Care. 2017;11:181–90. 10.1097/SPC.0000000000000292. - DOI - PubMed
    2. Boland EG, Ahmedzai SH. Persistent pain in cancer survivors. Curr OpSupportive Palliat Care. 2017;11:181–90. doi: 10.1097/SPC.0000000000000292. - DOI - PubMed
    1. Greco MT, Roberto A, Corli O, Deandrea S, Bandieri E, Cavuto S, et al. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol. 2014;32:4149–54. 10.1200/JCO.2014.56.0383. - DOI - PubMed
    2. Greco MT, Roberto A, Corli O, Deandrea S, Bandieri E, Cavuto S. et al. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol. 2014;32:4149–54. doi: 10.1200/JCO.2014.56.0383. - DOI - PubMed

LinkOut - more resources