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  • Author contributions br Janice Kwon

    2020-08-18

    Author contributions
    Janice Kwon: conceptualization, data curation, formal analysis, funding acquisition, investigation, methodology, project administration, writing - original draft and writing – review and editing; Anna Tinker: data curation; writing – review and editing; Gillian Hanley: formal anal-ysis, investigation, methodology, writing – review and editing; Gary Pansegrau: data curation, investigation, writing –review and editing; Sophie Sun: investigation, writing – review and editing; Mark Carey: in-vestigation, writing – review and editing; Intan Schrader: formal analy-sis, investigation, writing – review and editing.
    Financial support
    UBC Division of Gynecologic Oncology Research Award.
    References
    [3] Agency BC, Hereditary cancer program referral form 2015, Available from http:// www.bccancer.bc.ca/screening/Documents/HCP_Form-ReferralForm.pdf August 29, 2016. [4] Force USPST, Final recommendation statement: BRCA-related cancer: risk assess-ment, genetic counseling, and genetic testing 2013, Available from https://http:// www.uspreventiveservicestaskforce.org/Page/Document/ RecommendationStatementFinal/brca-related-cancer-risk-assessment-genetic-counseling-and-genetic-testing July 19, 2017.
    [11] Health BCMo, BC ministry of health medical services commission payment schedule 2017 [updated July 1, 2017; cited 2017 July 7, 2017], Available from http://www2. gov.bc.ca/gov/content/health/practitioner-professional-resources/msp/physicians/ payment-schedules/msc-payment-schedule.
    [26] Steiner CAA, Weiss AJTHA, Barrett MLMLB, Inc., Fingar KRTHA, Davis PHA, Trends in bilateral and unilateral mastectomies in hospital inpatient and ambulatory settings, 2005–2013, Rockville, MD 2016 Feburary 2016 (Report No).
    [27] AHRQ, Trends in Hysterectomies and Oophorectomies in Hospital Inpatient and Ambulatory Settings, 2005–2013, (Rockville, MD) 2016. [28] CMS, Physician fee schedule search 2017, Available from http://www.cms.gov/apps/ physician-fee-schedule/search/search-criteria.aspx July 7, 2017.
    [50] Program BCAHC, Risk-Reducing Surgery in BRCA AZD2281 Carriers, 2016.
    [53] BCCA, British Columbia Cancer Agency Hereditary Cancer Program: High Risk Clinic Statistics, 2017.
    Contents lists available at ScienceDirect
    Oral Oncology
    journal homepage: www.elsevier.com/locate/oraloncology
    Breakthrough pain in patients with head & neck cancer. A secondary analysis of IOPS MS study 
    T
    Sebastiano Mercadantea, , Francesco Masedub, Marco Valentib, Federica Aiellic
    a Main Regional Center for Pain Relief and Supportive/Palliative Care, La Maddalena Cancer Center, Palermo, Italy
    b Department of Biotechnological and Applied Clinical Sciences, Section of Clinical Epidemiology and Environmental Medicine, University of L'Aquila, L'Aquila, Italy
    c Department of Medical Oncology, AUSL Teramo, Italy
    Keywords:
    Head and neck cancer
    Cancer pain
    Breakthrough pain
    Opioids
    Fentanyl 
    Aim: To characterize breakthrough pain (BTcP) in patients with Head and neck (H&N) cancer.
    Methods: This was a secondary analysis of multicenter study of BTcP. Background pain intensity and opioid dose were recorded. The number of BTcP episodes, their intensity, predictability, onset, duration and interference with daily activities were collected. Opioids used for BTcP, and the mean time to meaningful pain relief after taking medication, were assessed. The presence of mucositis was also assessed.
    Results: 205 patients with H&N cancer were examined. The mean number of BTcP episodes was 2.8/day, which was higher than in general population. The mean intensity of BTcP was 7.4. BTcP was more predictable in H&N cancer than in other tumors. The main trigger of predictable BTcP was the ingestion of food (76.5%). BTcP onset was fast in 148 patients (72.2%). The mean time to meaningful pain relief after taking a BTcP medication was 15.3 min and BTcP interference with daily activity was relevant in most patients (89.2%). Transdermal drugs and nasal fentanyl preparations were more frequently used for background pain and BTcP, respectively. A consistent number of patients with H&N cancer (38.5%) exhibited different levels of oral mucositis.
    Conclusion: BTcP in patients with H&N cancer is characterized by a larger number of episodes/day and the predictability, particularly with ingestion of food. The use of drugs for background analgesia and BTcP were conditioned by the possible interference with swallowing or local mucosal damage.
    Introduction
    More than half million of new cases of head and neck (H&N) cancer are diagnosed worldwide each year, possibly due to rising alcohol and tobacco consumption and increased sun exposure, as well as human papilloma virus [1]. Patients with H&N cancer frequently experience pain, even long after the completion of treatment. The prevalence of pain among this population has been estimated at 70%, which is higher than what has been observed in other types of cancer [2]. Pain ex-perienced one year after diagnosis has been found to be predictive of poor quality of life, disability [3] and shorter survival [4], particularly in the advanced stage of disease [5]. Of interest, orofacial pain onset has been also reported to predict transition to H&N cancer [6].