Poster Presentation Cancer Survivorship 2019

Background: Cancer pain is not usually managed in pain clinics. Due to advances in screening and treatment, there are more cancer survivor. Managing treatment –related pain and comorbid pain is a growing survivorship issue. Since 2014, Patient Reported Outcomes for chronic pain have been standardized in Australia, under the Australasian Electronic Persistent Pain Outcomes Collaboration (ePPOC).¹ The aim of this study was to characterize the pain experience of cancer survivors seen at the pain clinic (PC) at Sydney’s Royal North Shore Hospital (RNSH) in the ePPOC era.

Method: All patients with a history of cancer who had an initial assessment in RNSH PC between 2013 and 2017 were identified from the EMR and their data were collected and entered into a database, including demographics, clinical details, and ePPOC questionnaire scores.  Data analysis included descriptive and comparative statistics.

Results: Of some 2800 patients seen in the 5 year period, 281 (10%) had a history of cancer.  42 were excluded from analysis (cancer pain, not seen, refused). Of the remaining 239, initial questionnaires were available in 212 (89%), of whom pain was attributed to cancer treatment in 82 (31%). The commonest cancers were breast 22, colorectal 7, heme 12, and melanoma 9, with prostate and lung uncommon. 52 (62%) of the cancer treatment-related pain syndromes were post-surgical. The mean scores on the ePPOC questionnaires (see table) indicate survivors have the same levels of unhelpful thoughts and beliefs about pain (catastrophising, sense of injustice, fear of moving and lack of confidence to cope).

Discussion: Cancer survivors were common in this pain clinic, though most were seen for comorbid chronic non-malignant pain. Survivors with treatment-related pain may benefit from learning cognitive behavioral strategies to help them cope better with their pain, without needing to take analgesics.

Table. Mean scores for cancer survivors, compared to clinic norms