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Characterization of cancer-induced bone pain: an exploratory study

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Abstract

Purpose

Cancer-induced bone pain (CIBP) is the commonest cause of pain in patients with cancer. Its association with increased morbidity combined with limitations of currently available therapies makes it a clinical challenge. Clinical characterization of this complex pain syndrome is essential in underpinning clinical management and informing future research. The aim of this exploratory study was to characterise CIBP using self-rating scales.

Patients and methods

A cross-sectional survey of patients with CIBP was carried out in a regional oncology centre. Patients described their pain over the preceding 24 h using the McGill Pain Questionnaire, Brief Pain Inventory (BPI), and a breakthrough pain questionnaire. Multiple linear regression analyses were conducted.

Results

Fifty-five patients were recruited. Annoying, gnawing, aching, and nagging were the most commonly used words to describe CIBP. From the BPI, median average pain was 4/10 and worst pain was 7/10 on a 0–10 Numerical Rating Scale. The worst pain score correlated more strongly with BPI interference score (p = 0.001). Forty-one patients had breakthrough pain. Patients with breakthrough pain had higher total BPI interference scores than those with no breakthrough pain; median (IQR); 35.0 (2.5–44.7) vs. 18.5 (5.5–26.7), p < 0.01. Of the patients, 20/41 (48%) had breakthrough pain of rapid onset (less than 5 min) and short duration (less than 15 min).

Conclusion

In CIBP, worst pain most accurately reflects the characteristics of pain flares and functional impairment. Breakthrough pain is often unpredictable, sudden onset and short duration. Further characterization studies of CIBP in the broader cancer population are needed

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Conflict of interest statement

None declared. The authors have full control of all primary data and agree to allow the journal to review their data if requested.

Author information

Authors and Affiliations

  1. St Margaret’s of Scotland Clinician Scientist in Palliative Medicine, Edinburgh Cancer Research Centre, University of Edinburgh, Western General Hospital, Crewe Road South, Edinburgh, EH4 2XR, UK

    Barry J. A. Laird

  2. Accord Hospice, Glasgow, UK

    John Walley

  3. University of Edinburgh, Edinburgh, UK

    Gordon D. Murray, Eleanor Clausen & Marie T. Fallon

  4. Western General Hospital, Edinburgh, UK

    Lesley A. Colvin

Authors
  1. Barry J. A. Laird
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  2. John Walley
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  3. Gordon D. Murray
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  4. Eleanor Clausen
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  5. Lesley A. Colvin
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  6. Marie T. Fallon
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Corresponding author

Correspondence to Barry J. A. Laird.

Additional information

Previous presentation of manuscript: general poster session, British Pain Society, Annual Scientific Meeting 2009

Barry J A Laird and John Walley are joint first authors. Lesley A Colvin and Marie T Fallon are joint senior authors.

Research support

Dr. Laird is supported by St Margarets of Scotland Hospice and has received grants from the National Cancer Research Institute (SuPaC Fellowship) and the Beatson Oncology Centre, Glasgow, UK. Professor M. Fallon has received educational grants from Pfizer and Archimedes.

Appendix 1—Breakthrough Pain Questionnaire

Appendix 1—Breakthrough Pain Questionnaire

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Laird, B.J.A., Walley, J., Murray, G.D. et al. Characterization of cancer-induced bone pain: an exploratory study. Support Care Cancer 19, 1393–1401 (2011). https://doi.org/10.1007/s00520-010-0961-3

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  • DOI: https://doi.org/10.1007/s00520-010-0961-3

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