TREATMENT OUTCOME IN A MULTIDISCIPLINARY CANCER PAIN CLINIC

The early and long-term effect of multimodal pain management was studied in 200 cancer patients referred consecutively to a multidisciplinary cancer pain clinic from the departments of medical and surgical oncology. At the initial contact 186 patients presented with a pain problem. Of these, 172 patients had pain in motion, 144 had pain at rest and 124 had pain that interrupted sleep. After 1-2 weeks of treatment the early effect could be evaluated in 131 patients: pain at rest, 108 before and 35 after; pain in motion, 123 before and 83 after; pain interrupting sleep, 92 before and 20 after. The over-all pain relief reported by 131 patients was: none 14; slight 17; moderate 25; considerable 65; complete 10. During this period the modalities of pain management were medical: analgesic tailoring, non-neurolytic blockades, epidural opioid therapy and combinations of these. The long-term effect of multidisciplinary pain treatment was evaluated by questionnaires 4-29 weeks after referral. The pain relief reported by 65 patients was: none 7; slight 8; moderate 13; considerable 31; complete 6. In 55 patients pain relief had remained stable or had changed only one step. These patients had continued medical pain treatment supplemented by psychological intervention and social worker assistance for selected cases.