The Prevalence and Nature of Cancer-Related Neuropathic Pain in Out-Patient Services in Spain

Cancer patients with neuropathic pain have been shown to have higher levels of pain interference and impaired quality of life (QoL) compared with cancer patients without neuropathic pain. This article presents sub-analysis of data from a large non-interventional study conducted between 23 August 2010 and 22 July 2011 in Denmark, Germany, Greece, Spain and the UK. Descriptive data collected in 21 oncology or palliative care centers during patients' routine out-patient visits in Spain are reported here to further investigate the prevalence and nature of cancer-related neuropathic pain (CRNP). The prevalence of CRNP in 557 cancer patients with chronic pain in Spain was estimated at 30.9% (95% confidence interval (CI): 27.0-34.7) by physicians before considering scores on the PainDETECT questionnaire and 30.7% (95% CI: 26.9-34.5) after considering PainDETECT scores. Despite a similar overall number, there were shifts in the numbers of patients with or without a diagnosis of CRNP after physicians had had the opportunity to consider PainDETECT scores, particularly for patients who received an initial diagnosis of 'unknown'. In the opinion of the physicians, 92/171 (53.8%) of the CRNP population had mixed cancer-related pain with a neuropathic component, which can be difficult to identify and effectively manage. The self-reported responses to questions and scales in this Spanish sample indicated that many aspects of daily functioning were negatively impacted within the CRNP participants and that pain was not always controlled. These data highlight the need for national guidelines to identify and treat cancer-related pain with a neuropathic component.