Despite increased attention to
cancer pain,
pain prevalence in patients with
cancer has not improved over the last decade and one third of
cancer patients on anticancer
therapy and half of patients with advanced disease still suffer from moderate to severe
pain. In this review, we explore the possible reasons for the ongoing high prevalence of
cancer pain and discuss possible future directions for improvement in personalised
pain management. Among possible reasons for the lack of improvement are: Barriers for patients to discuss
pain with clinicians spontaneously;
pain measurement instruments are not routinely used in daily practice; limited knowledge concerning the assessment of undertreatment; changes in patients' characteristics, including the ageing of the population; lack of significant improvement in the treatment of
neuropathic pain; limitations of pharmacological treatment and lack of evidence-based nonpharmacological treatment strategies. In order to improve
cancer pain treatment, we recommend: (1) Physicians proactively ask about
pain and measure
pain using assessment instruments; (2) the development of an optimal tool measuring undertreatment; (3) educational interventions to improve health care workers' skills in
pain management; (4) the development of more effective and personalised pharmacological and nonpharmacological
pain treatment.