Oncology Medical News about Cancer Pain; Neuropathic Origin

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Tools for Identifying Cancer Pain of Predominantly Neuropathic Origin and Opioid Responsiveness in Cancer Patients
The Journal of Pain, 05/13/09

Mercadante S et al. - The aim of this study was to explore the value of evaluation tools such as Neuropathic Pain Questionnaire (NPQ), complete and short form (NPQ-SF), Leeds Assessment of Neuropathic Signs and Symptoms (LANSS) and Neuropathic Pain Symptom Inventory (NPSI)...Patients with the highest values of assessment tools were also more likely to be clinically labeled as definite NP, although sensibility and specificity were low. Patients with a clinical diagnosis of definite NP, possible NP, or unlikely NP showed significant differences in opioid response. Patients with "unlikely NP" had a lower pain intensity at T1, and patients with "definite NP" required more intensive treatment. Patients requiring more aggressive treatment showed significantly higher values of Opioid Escalation Index (OEI)mg. Screening tools may provide a basis to suggest a common language in cancer pain syndromes. This study also confirms that opioids are clinically effective in "definite NP" conditions although a more aggressive treatment requiring careful utilization of opioids and symptomatic drugs is strictly necessary.

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