• Vol. 41 No. 9, 407–416
  • 15 September 2012

Recent Non-Interventional Advances in Cancer Pain Among Singapore Patients



Introduction: Pain is a common symptom in cancer patients, but very little information about the prevalence, severity, and treatment of pain in cancer patients in Singapore is available. Therefore, our prospective survey in the National Cancer Centre (NCC) outpatients is incorporated in this report. In addition, a review concerning the recent advances on non-interventional pain management in cancer treatment, which is relevant in the context, is discussed.

Materials and Methods: For the prospective survey, a questionnaire was distributed for self-administration by patients while waiting for consultation at the NCC outpatient departments. Literature searches on advances in pain management were conducted, reviewed and discussed.

Results: In the last decade, there have been advances in pain pharmacology ranging from wider therapeutic options and management approaches to novel delivery techniques. Acupuncture and massage therapy became increasingly popular among cancer patients. Some clinical trials of acupuncture show benefits in palliation of cancer pain. From the prospective survey, 41.2% of the responders reported pain in the past week, and only 70.8% talked to their doctors about their pain. One third of the patients received analgesics. Of these, 86.5% said that they were taking the prescribed medications, however, 37.4% admitted to having difficulties taking them. Non-drug methods were used by 25.4% of the patients. Medicated oil, cream or gel was used by 49.3%; only 2.6% reported use of Chinese herbs.

Conclusion: Pain is a significant symptom in outpatients attending a cancer centre, affecting 41.2% of the patients. Although majority of patients who suffered from pain reported this to doctors, much more medical effort is needed to help patients to relieve their pain and proper complementary therapy could be considered.

Unrelieved pain is one of the most feared symptoms in cancer. As a result of pain, the quality of life of cancer patients is impaired. Since the first release of the World Health Organization (WHO) guidelines for the management of cancer pain, in the past 2 to 3 decades, numerous studies have been reported with the aim to improve the quality of life of patients. Although the WHO guidelines for pain relief are effective, pain remains a problem among cancer patients. Among hospitalised cancer patients, pain was reported to be the most common symptom in overseas as well as in Singapore context. Among the outpatient and ambulatory cancer patients, the distress and problem of pain reported recently did not appear to be much better either. Of note, prevalence rates for pain reported could range from 20% to 80%. This wide range can be due to the different stages of cancer, percentage of localised and metastatic diseases, cultural perception in pain, availability of pain management and method used to determine the rates of pain prevalence. Equally important are considerations for the cause of pain, whether the pain is due to non-compliance to the prescribed analgesics, or the reasons that drive such non-compliance.

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