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AAPT Diagnostic Criteria for Chronic Cancer Pain Conditions
Highlights
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- No comprehensive, universally accepted cancer pain classification system currently exists.
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- An evidence-based taxonomy would enhance cancer pain research efforts by providing consistent diagnostic criteria, ensuring comparability across clinical trials.
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- As part of a collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks (ACTTION) and the American Pain Society (APS), the ACTTION-APS Pain Taxonomy (AAPT) initiative worked to develop the characteristics of an optimal diagnostic system for cancer pain.
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- Diagnostic criteria were developed for three chronic pain syndromes associated with cancer (i.e., bone pain and pancreatic cancer pain as models of pain related to a tumor) or its treatment (i.e., chemotherapy-induced peripheral neuropathy). Future efforts will subject these diagnostic categories and criteria to systematic empirical evaluation of their feasibility, reliability and validity and extension to other cancer-related pain syndromes.
Abstract
Chronic
cancer pain is a serious complication of malignancy or its treatment.
Currently, no comprehensive, universally accepted cancer pain
classification system exists. Clarity in classification of common cancer
pain syndromes would improve clinical assessment and management.
Moreover, an evidence-based taxonomy would enhance cancer pain research
efforts by providing consistent diagnostic criteria, ensuring
comparability across clinical trials. As part of a collaborative effort
between the Analgesic, Anesthetic, and Addiction Clinical Trial
Translations Innovations Opportunities and Networks (ACTTION) and the
American Pain Society (APS), the ACTTION-APS Pain Taxonomy (AAPT)
initiative worked to develop the characteristics of an optimal
diagnostic system.59, 65 Following the establishment of these
characteristics, a working group consisting of clinicians and clinical
and basic scientists with expertise in cancer and cancer-related pain
was convened to generate core diagnostic criteria for an illustrative
sample of 3 chronic pain syndromes associated with cancer (i.e., bone
pain and pancreatic cancer pain as models of pain related to a tumor) or
its treatment (i.e., chemotherapy-induced peripheral neuropathy). A
systematic review and synthesis was conducted to provide evidence for
the dimensions that comprise this cancer pain taxonomy. Future efforts
will subject these diagnostic categories and criteria to systematic
empirical evaluation of their feasibility, reliability and validity and
extension to other cancer-related pain syndromes.
Perspective
The
ACTTION-APS chronic cancer pain taxonomy provides an evidence-based
classification for 3 prevalent syndromes, namely malignant bone pain,
pancreatic cancer pain, and chemotherapy-induced peripheral neuropathy.
This taxonomy provides consistent diagnostic criteria, common features,
co-morbidities, consequences, and putative mechanisms for these
potentially serious cancer pain conditions that can be extended and
applied with other cancer-related pain syndromes.
Key words
- Cancer pain;
- taxonomy;
- bone pain;
- chemotherapy-induced peripheral neuropathy;
- pancreatic cancer
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