Abstract
We can anticipate that failure to assess cancer pain adequately will inevitably lead
to inappropriate application of pain management options. However, it is not always
standard practice to teach the limitations of the question ‘How bad is the pain?’,
as well as the need to consider what may complicate pain management or be a poor prognostic
factor for pain control. These issues may complicate cancer pain assessment and require
specialist consultation. An internationally accepted classification system for cancer
pain could provide the basis for a multidimensional assessment and a common language
for clinical and research work. Research dating back to the late 1980s has resulted
in the development of the Edmonton Classification System for Cancer Pain. This includes
many of the factors that may be prognostic for the complexity of cancer pain management
and can assist an inexperienced clinician in anticipating the need for specialist
advice.
Keywords
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References
- The pharmacologic management of cancer pain.Oncology. 2004; 18: 1499-1524
- Pain in terminally ill patients. Guidelines for pharmacological management.CNS Drugs. 2003; 17: 621-631
- American pain society recommendations for improving the quality of acute and cancer pain management.Arch Intern Med. 2005; 165: 1574-1580
- Meeting the challenges in cancer pain management.J Support Oncol. 2004; 2: 5-22
Fainsinger RL, Nekolaichuk CL, Lawlor PG, Neumann CM. Edmonton classification system for cancer pain (ECS-CP). <http://www.palliative.org/PC/Clinicalinfo/AssessmentToolsIDX.html>.
- Multidimensional assessment in palliative care.in: Bruera E. Higginson I.J. Ripamonti C. von Gunten C. Textbook of palliative medicine. Hodder Arnold, 2006: 319-332
- Opioid use in advanced malignant disease: why do different centres use vastly different doses? A plea for standardized reporting.J Pain Symptom Manage. 1995; 10: 632-638
- A “TNM” system for evaluating and treating cancer pain. The Edmonton classification system.Oncol Exchange. 2005; 5: 14-17
- An international survey of cancer pain characteristics and syndromes. IASP task force on cancer pain. International association for the study of pain.Pain. 1999; 82: 263-274
- Implications of recent advances in the understanding of pain pathophysiology for the assessment of pain in patients.Pain. 1999; : S141-S147
- Pain analysis in prediction of treatment outcome.Acta Anaesth Scand. 1998; : 24-28
- Development of a cancer pain prognostic scale.J Pain Symptom Manage. 2002; 24: 366-378
- Clinical symptoms and co-morbidity: significance for the prognostic classification of cancer.Cancer. 1996; 77: 834-842
- The Edmonton staging system for cancer pain: preliminary report.Pain. 1989; 37: 203-209
- A prospective multicentre assessment of the Edmonton staging system for cancer pain.J Pain Symptom Manage. 1995; 10: 348-355
- Clinical efficacy and safety of a novel controlled-release morphine suppository and subcutaneous morphine in cancer pain: a randomized evaluation.J Clin Oncol. 1995; 13: 1520-1527
- A randomized, double-blind, double-dummy, crossover trial comparing the safety and efficacy of oral sustained-release hydromorphone with immediate-release hydromorphone in patients with cancer pain. Canadian Palliative Care Clinical Trials Group.J Clin Oncol. 1996; 14: 1713-1717
- Custom-made capsules and suppositories of methadone for patients on high-dose opioids for cancer pain.Pain. 1995; 62: 141-146
- Opioid rotation for toxicity reduction in terminal cancer patients.J Pain Symptom Manage. 1995; 10: 378-384
- A randomized, controlled trial of intravenous clodronate in patients with metastatic bone disease and pain.J Pain Symptom Manage. 1997; 13: 319-326
- Opioids, confusion in opioid rotation.Palliative Med. 1998; 12: 463-464
- A multicentre validation study of the Revised Edmonton Staging System for classifying cancer pain in advanced cancer patients.J Pain Symptom Manage. 2005; 29: 224-237
- A validation study of a pain classification system for advanced cancer patients using content experts: the Edmonton classification system for cancer pain.Palliative Med. 2005; 19: 466-476
- Should the rate of opioid dose escalation be included as a factor in a Cancer Pain Classification System?.J Pain Symptom Manage. 2008; 35: 51-57
- Is pain intensity predictive for complexity of Cancer Pain?.Palliative Med. 2006; 20: 269
Article info
Publication history
Published online: March 25, 2008
Accepted:
February 25,
2008
Received:
January 31,
2008
Identification
Copyright
© 2008 Elsevier Ltd. Published by Elsevier Inc. All rights reserved.
