Journal of Pain Research (Oct 2022)
The Burden of Metastatic Cancer–Induced Bone Pain: A Narrative Review
Abstract
Ann Colosia,1 Annete Njue,2 Zahid Bajwa,3 Erika Dragon,4 Rebecca L Robinson,5 Kristin M Sheffield,5 Sheena Thakkar,6 Steven H Richiemer7 1Department of Market Access and Outcomes Strategy, RTI Health Solutions, Research Triangle Park, NC, USA; 2Department of Market Access and Outcomes Strategy, RTI Health Solutions, Manchester, UK; 3Medical Affairs, Eli Lilly and Company, Indianapolis, IN, USA; 4Medical Affairs, Pfizer, Ltd, Budapest, Hungary; 5Value, Evidence, and Outcomes, Eli Lilly and Company, Indianapolis, IN, USA; 6Patient Health & Impact, Pfizer Inc, New York, NY, USA; 7Division of Pain Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USACorrespondence: Rebecca L Robinson, Eli Lilly and Company, Lilly Corporate Center, Indianapolis, IN, 46285, USA, Tel +1 3174331323, Fax +1 3172777444, Email [email protected]: Bone pain is one of the most common forms of pain reported by cancer patients with metastatic disease. We conducted a review of oncology literature to further understand the epidemiology of and treatment approaches for metastatic cancer–induced bone pain and the effect of treatment of painful bone metastases on the patient’s quality of life. Two-thirds of patients with advanced, metastatic, or terminal cancer worldwide experience pain. Cancer pain due to bone metastases is the most common form of pain in patients with advanced disease and has been shown to significantly reduce patients’ quality of life. Treatment options for cancer pain due to bone metastases include nonsteroidal anti-inflammatory drugs, palliative radiation, bisphosphonates, denosumab, and opioids. Therapies including palliative radiation and opioids have strong evidence supporting their efficacy treating cancer pain due to bone metastases; other therapies, like bisphosphonates and denosumab, do not. There is sufficient evidence that patients who experience pain relief after radiation therapy have improved quality of life; however, a substantial proportion are nonresponders. For those still requiring pain management, even with available analgesics, many patients are undertreated for cancer pain due to bone metastases, indicating an unmet need. The studies in this review were not designed to determine why cancer pain due to bone metastases was undertreated. Studies specifically addressing cancer pain due to bone metastases, rather than general cancer pain, are limited. Additional research is needed to determine patient preferences and physician attitudes regarding choice of analgesic for moderate to severe cancer pain due to bone metastases.Keywords: cancer, pain, bone, metastasis, quality of life, cancer patients
