Transformation of Acute Cancer Pain to Chronic Cancer Pain Syndromes

Early detection and advances in cancer treat­ments have resulted in improved control over progression of malignancies, turning cancer into a chronic disease for many long-term cancer survivors. Approximately 12 million people with a previous diagnosis of cancer are living in the United States, and more than two-thirds of individuals diagnosed with cancer are expected to live at least 5 years after diagnosis. The National Coalition for Cancer Survivorship notes that from “the moment of diagnosis and for the balance of life, an individual diagnosed with cancer is a survivor.” Cancer survivorship may also be described as constituting three distinct phases of treatment: the acute phase (from diag­nosis until completion of the initial treatment), the extended phase (the period of partial or com­plete remission after the initial treatment), and the permanent survival phase (a period of low likelihood of primary disease returning). Despite the advances in cancer therapies, sur­vivors face a number of challenges, including an increased risk of recurrent cancer and other med­ical treatment-related toxicities. Mariotto et al estimated that as of January 1, 2005, there were more than 300,000 survivors of childhood cancer in the United States. Of these survivors, approx­imately one-quarter have lived for more than 30 years; however, only a small fraction of survivors (3%) exceeded 60 years of age. The most com­mon cancer diagnoses among the survivors were brain cancer, acute lymphoblastic leukemia, germ cell tumors, and Hodgkin’s lymphoma. An­other report showed that 75% of childhood can­cer survivors experienced at least one adverse event.

*For a PDF of the full article and accompanying viewpoints by Tom Strouse and Howard Rosner along with Laura Audell, click in the links to the left of this introduction.