CN27 - Pain in men with metastatic castration-resistant prostate cancer (mCRPC) starting their first-line of life prolonging treatment: A cross sectional study in Sweden

Background

Men with metastatic castration-resistant prostate cancer (mCRPC) have an incurable disease and along with prolonging life, symptom management is one of the main goals in treatment of these men. Most of these men have bone metastases and a high frequency report pain. However, to be able to achieve an effective pain management, and to evaluate effects of treatments on pain in a real-world situation, not only knowledge of frequency is important. Today there are no studies describing different dimensions of pain, such as severity and distress, in men with mCRPC starting life-prolonging treatments in a real-world situation. The aim was to describe the multidimensional aspects of pain from the perspective of frequency, severity and distress, and analgesic use in men with mCRPC, starting a first-line life-prolonging treatment.

Methods

Data was taken from a prospective study (n=143) where 72 men with mCRPC starting their first-line of life-prolonging treatment and reported pain were included. Three dimensions of pain (frequency, severity and distress) were measured using the Memorial System Assessment Scale (MSAS) and the use of analgesics was collected from medical records.

Results

Of the 72 men who reported pain on the MSAS, 63.9% (n=46) used analgesics while 36.1% (n=26) did not. Of the men using analgesics, 55.8 % reported pain “frequently” or “almost constantly” and among the men not using analgesics, 44.0% reported that they had pain “frequently” or “almost constantly”. Of those using analgesics, 27.5% reported severe or very severe pain, while none of the men not using analgesics reported very severe pain, and 19% reported severe pain. Of the men using analgesics 51% reported quite a bit/very much distress in contrast to 38% of the men not using analgesics.

Conclusions

Pain management was not sufficient for more than half of the men, even for those receiving analgesics. Men with mCRPC starting life-prolonging treatment may benefit from a structured multidimensional assessment. When the disease has progressed to a mCRPC phase, an early integrated palliative approach with thorough symptom management may be essential in order to obtain the best possible quality of life.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.