Pain management in cancer survivorship

Background. The number of patients surviving cancer disease has increased in last decades. Consequently, an emerging population with different needs due to long-term or late effects of cancer disease and/or treatment, e.g. chronic pain, is of major concern. Epidemiology. Chronic pain is one of the main problems in this population and prevalence varies between 16% and 50%. Most information derives from breast cancer patients assessed by surveys from national or local institutional databases. A Danish population-based survey estimated that 41.5% of all cancer survivors reported chronic pain. Pain etiology. Neuropathic pain seems to be the major pain etiology in cancer survivors and therefore adjuvant analgesics should be the first choice of analgesic treatment. Context. This article addresses the central aspects of pain epidemiology, mechanisms and the frequent pain syndromes met in cancer survivors. Pain management strategies are discussed according to the biopsychosocial model and with the rapidly growing number of cancer survivors the establishment of multidisciplinary clinics as a part of comprehensive cancer centers are proposed.