Pain is one of the most common and painful symptoms for cancer patients, especially those with advanced cancer, but many people think that cancer pain can only be endured. In fact, cancer pain can be relieved through standardized whole-process management.
On March 2, the kick-off meeting of the "2024 Guangdong Provincial Training Course for the Accurate Management of Cancer Pain in National County Medical and Health Institutions" hosted by the Capacity Building and Continuing Education Center of the National Health Commission and undertaken by Union Shenzhen Hospital of Huazhong University of Science and Technology (Nanshan Hospital) (hereinafter referred to as "Nanshan Hospital") was held, marking the official settlement of the first batch of cancer pain management bases in national county-level health institutions in Nanshan Hospital. There are only 20 bases in the country, and only one in Guangdong Province, Nanshan Hospital.
At the meeting, Professor Fan Bifa, the leader of the project team for improving the precision ability of cancer pain management throughout the whole process, Professor Wang Yong of the Aviation General Hospital of China Medical University, the executive team leader, Professor Li Shuiqing, director of the Pain Department of Peking University Third Hospital, and other domestic experts in the field of pain and oncology, as well as experts from Nanshan Hospital Base, gave detailed explanations and lectures on pain assessment and diagnosis, psychological and drug treatment of cancer pain, patient management, palliative care, etc., to promote the sharing of educational resources. Improve the skills and level of relevant clinicians in county-level medical and health institutions. More than 100 clinical doctors from 12 county-level medical institutions inside and outside the province, including Suzhou, Shenzhen, Dongguan, Foshan and Zhongshan, participated in the training.
Cancer patients have a low desire for pain, and the norm of cancer pain is less than 20%.
When the cancer pain came, it really hurt so much that I wanted to die, as if I was tortured, and someone kept giving you electric shocks. "The moment a grain of rice enters the mouth, the cancer pain begins, just like eating is not rice, but needles, and the needles hurt wherever they go. ”…In the pain ward of Nanshan Hospital, Grandpa Liao (pseudonym), a 76-year-old patient with advanced lung cancer, felt that he had experienced another "pain" as soon as he mentioned the cancer pain.
He said that he has been diagnosed with lung cancer for many years and has been able to accept the consequences calmly, but every time the cancer pain comes, he will always be afraid for a while, "because it is so painful that I don't even dare to remember." However, this kind of pain has rarely been experienced since he entered the pain department of Nanshan Hospital to receive standardized cancer pain, "I still came to the hospital late, I knew that cancer pain could be **, I should have brought him over earlier, so that he could experience less pain." Son Mr. Liao (pseudonym) said.
According to data from the National Cancer Center, there were 482 new cases of cancer in China in 2022470,000, and the total number of cancer deaths was 257420,000, which means that every minute, 8 people are diagnosed with cancer and 6 people die from cancer. Cancer pain is the most common and unbearable symptom of cancer patients, especially in patients with advanced cancer pain, the pain is severe, and the incidence of cancer pain is 75%.
However, cancer pain** has not attracted everyone's attention in China. According to the survey, 70% of patients with advanced cancer believe that cancer pain is the main symptom, 5 at home and 60 in the hospital endure pain at the end of life, and 25 cancer patients die with severe pain.
At present, the proportion of cancer pain patients in China who accept regular ** is still very low, maybe less than 1 5, many cancer pain patients are still relatively poor in the initiative of pain **, feel the pain and endure it, and still endure the pain for 10 days. Professor Wang Yong, executive leader of the National Cancer Pain Management Project Team and Professor of Beijing Aviation General Hospital, said that at present, the desire of cancer patients in China for cancer pain is still relatively low, and the lack of cancer pain is still a common phenomenon. If patients with cancer pain can undergo regular**, they can prolong their life by 3-6 months.
Focus on primary medical institutions and comprehensively improve the ability to manage cancer pain throughout the process
In fact, the standardized management of each cancer pain patient can not only avoid "short pain" from becoming "long pain", reduce pain, but also improve the quality of life of patients and even prolong survival.
The whole process of cancer pain management refers to the standardized management of the whole process from early assessment, follow-up to post-management, which can enable patients to obtain better efficacy. A study showed that after the whole process of cancer pain management intervention, the compliance rate of patients with medication increased from 61% to 98%, and the incidence of outbreak pain decreased from 68% to 10%, which effectively improved the quality of life of patients.
In recent years, the state has paid more and more attention to the whole process of cancer pain management, and a series of policy documents have been issued to promote the standardized management of cancer pain in hospitals, especially to reduce the management level between hospitals and improve the cancer pain management capacity of county hospitals. In September 2023, the Capacity Building and Continuing Education Center of the National Health Commission launched the "County Medical and Health Institutions Accurate Management Capacity Improvement Project", and Nanshan Hospital was successfully selected as one of the first 20 training bases in the country.
The project plans to select 60 hospitals as project training bases within 5 years, each base will train at least 5 county-level medical and health institutions every year, and complete the training of 1,500 county-level medical institutions within 5 years, so as to improve the ability of medical staff in county-level medical units to manage cancer pain throughout the whole process, improve their ability to undertake the triage of cancer pain patients, establish a standardized system for cancer pain diagnosis and treatment, and establish a national cancer pain diagnosis and treatment alliance to facilitate the medical treatment, diagnosis and treatment of cancer pain patients across the country.
Professor Fan Bifa, President of the Pain Physician Branch of the Chinese Medical Doctor Association, Leader of the Expert Group of the Cancer Pain Management Project, and Professor of China-Japan Friendship Hospital, said that the biggest feature of this project is to focus on the grassroots level, and establish the concept, technology, and program of cancer pain that are urgently needed by the grassroots level, as well as the pain medical team that can be retained at the grassroots level. Standardized and homogeneous diagnosis and treatment services are also one of the purposes of promoting hierarchical diagnosis and treatment and solving the difficulty of seeing a doctor.
The "national team" of pain diagnosis and treatment takes the lead to let cancer patients achieve "peace and happiness".
Many cancer pain patients often 'don't want to live' in the middle and advanced stages, but here, after the whole process of cancer pain management, cancer pain patients can achieve 'peace of mind', even when it is time to leave, it is not so painful. Professor Xiong Donglin, chairman of the Pain Committee of the Chinese Association of Integrative Medicine and professor Xiong Donglin of Huazhong University of Science and Technology Union Shenzhen Hospital (Nanshan Hospital), said.
As one of the first 20 training bases in China, the Department of Pain of Nanshan Hospital is a national key clinical specialty and a pain diagnosis and treatment center in Guangdong Province, ranking third in the country in the Fudan edition of the "2022 China Hospital Comprehensive Ranking". Since 2003, the department has been using intrathecal drug infusion system implantation to solve refractory cancer pain for more than 20 years, and has pioneered the use of opioids and local anesthetics to promote the nation.
In recent years, it has held minimally invasive training courses on cancer pain every year, led the establishment of the Refractory Cancer Pain Alliance in 2015, and has been joined by 35 hospitals, and in 2022, it will also become a pilot department of palliative care in Shenzhen. From the screening and evaluation of cancer pain to the resolution of refractory cancer pain, and then to the management of cancer pain at the end of life, in the pain department of Nanshan Hospital, the standardized and professional pain management from the occurrence of cancer pain to the end of life has been truly realized.
Professor Xiong Donglin said that as the only selected base in Guangdong Province, the multidisciplinary team of cancer pain management in Nanshan Hospital will carry out cancer pain training and technology promotion in a down-to-earth manner, and will carry out 2 centralized trainings every year, more than 10 fixed-point trainings for cultivation units, as well as offline guidance and discussion of difficult cases, etc., and strive to build the base into a benchmark base based in Shenzhen and radiating South China, and promote the development of cancer pain in Guangdong Province in a more standardized, comprehensive and accurate direction, benefiting more patients in South China.
Written by: Nandu reporter Li Rong correspondent Huang Jiabin Xiang Yuhang