Pain and Interventions in Stage IV Non-Small Cell Lung Cancer: A Province-Wide Analysis

• Published in: Current oncology (Toronto) Vol. 30; no. 3; pp. 3461 - 3472
• Main Authors: Tan, Vivian S, Tjong, Michael C, Chan, Wing C, Yan, Michael, Delibasic, Victoria, Darling, Gail, Davis, Laura E, Doherty, Mark, Hallet, Julie, Kidane, Biniam, Mahar, Alyson, Mittmann, Nicole, Parmar, Ambika, Tan, Hendrick, Wright, Frances C, Coburn, Natalie G, Louie, Alexander V
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 01.03.2023; MDPI
• Subjects: Aged; Analysis; Carcinoma, Non-Small-Cell Lung - complications; Carcinoma, Non-Small-Cell Lung - therapy; Cohort Studies; Comorbidity; Humans; Lung cancer, Non-small cell; Lung cancer, Small cell; Lung Neoplasms - complications; Lung Neoplasms - therapy; Medical research; Medicine, Experimental; non-small cell lung cancer; Ontario - epidemiology; pain; Pain - epidemiology; Pain - etiology; Palliative treatment; patient-reported outcomes; quality of life; Radiotherapy; Ontario; Alberta; Canada; non-small cell lung cancer; patient-reported outcomes; pain; quality of life
• ISSN: 1718-7729; 1198-0052; 1718-7729
• DOI: 10.3390/curroncol30030262

Pain is a common symptom in stage IV non-small cell lung cancer (NSCLC). The objective of the study was to examine the use of interventions and factors associated with interventions for pain. A population-based cohort study in Ontario, Canada was conducted with patients diagnosed with stage IV NSCLC from January 2007 to September 2018. An Edmonton Symptom Assessment System (ESAS) score of ≥4 defined moderate-to-severe pain following diagnosis. The study cohort included 13,159 patients, of which 68.5% reported at least one moderate-to-severe pain score. Most patients were assessed by a palliative care team (85.4%), and the majority received radiation therapy (73.2%). The use of nerve block was rare (0.8%). For patients ≥65 years of age who had drug coverage, 59.6% received an opiate prescription. Patients with moderate-to-severe pain were more likely to receive palliative assessment or radiation therapy compared to patients with none or mild pain. Patients aged ≥70 years and with a greater comorbidity burden were associated with less likelihood to receive radiation therapy. Patients from rural/non-major urban residence and with a greater comorbidity burden were also less likely to receive palliative care assessment. Factors associated with interventions for pain are described to inform future symptom management in this population.