Cancer-Related Pain: Prevalence, Severity and Management in a Tertiary Care Center in the Middle East

Abstract

Background: Despite pain awareness and the development of treatment guidelines, cancer-related pain assessment<br />and management remain suboptimal. Our objectives were to estimate the prevalence and severity of pain and its<br />interference with daily activities, and evaluate adequacy of treatment in cancer patients in Lebanon. Methods: A<br />total of 400 cancer patients aged 18 and above were interviewed at the American University of Beirut Medical Center<br />surgical and medical oncology floors, outpatient clinics and chemotherapy units from March 2016-February 2017. The<br />subjects covered were socio-demographics, clinical data, and presence of pain in the past month with use of the Brief<br />Pain Inventory questionnaire. Descriptive statistics were conducted using t-test, chi-square and Fischer's exact tests.<br />Pearson's correlation coefficients were used to examine relationships between pain severity and pain interference.<br />Logistic regression was employed to determine risk factors for pain. Results: The majority of participants were Lebanese<br />(76.0%), females (62.7%), married (80.2%), of Muslim faith (64.2%), of urban residence (85.8%), and with insurance<br />plans (81.3%). Most had breast cancer (38.8%), were stage 4 (52.7%) and underwent a combination of surgery and<br />systemic therapy (55.1%). The prevalence of pain in the past month was 29.8%. Among patients with pain, the highest<br />proportion had moderate pain (37.8%) and around 46% received inadequate treatment. Conclusion: More awareness<br />about cancer-related pain is needed to improve pain management and encourage referral to palliative care and pain<br />specialists early-on in diagnosis of disease.