Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology

Background: Lung cancer is one of the commonest cancers to cause pain, but little is known regarding the extent of this complex problem in these patients. Methods: Medline (1966-June 2002) and Cancerlit (1975-May 2002) were searched to identify studies of lung cancer patients' experience of pain, its prevalence, causes and underlying pathophysiology. Results: Thirty-two studies were identified. Patients were recruited from diverse populations, and the prevalence varied according to study setting. Pain affected 27% of outpatients (range 8-85%), and 76% of patients cared for by palliative care services (range 63-88%). Pain was caused by cancer in 73% (range 44-87%), and cancer treatment in 11% (range 5-17%). Nociceptive pain was the major pathophysiological subtype in lung cancer pain, but neuropathic pain accounted for 30% (range 25-32%) of cases. Conclusions: The overall weighted mean pain prevalence of pain was 47% (range 6-100%). Cancer patients should be asked about pain at all stages of management. Those with pain should be investigated for disease progression and considered for referral for specialist management. (C) 2003 Elsevier Ireland Ltd. All rights reserved.