{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:31:44Z","timestamp":1764221504066,"version":"3.46.0"},"reference-count":49,"publisher":"MDPI AG","issue":"23","license":[{"start":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T00:00:00Z","timestamp":1764028800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Sanofi"},{"name":"Clarivate"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Background and objective: Typical endpoints in cancer clinical trials focus on standardized efficacy endpoints, such as overall survival. Pain is not always assessed, although it is a highly prevalent and distressing aspect of patients\u2019 cancer experience and plays a critical role in health-related quality of life. To inform future pain measurement strategies in oncology, this targeted literature review of pain-related qualitative publications in oncology aimed to characterize and explore the patient experience of pain, and its impact on how patients feel and function. Methods: A review of publications in MEDLINE, Embase and PsycINFO from 2018 to 2023 was conducted. Patient quotes or author descriptions\/interpretations were extracted and analyzed with directed content analysis techniques, using ATLAS.ti v9. Data were synthesized to inform the development of a conceptual model. Results: Twenty-eight publications, with data from 534 patients across different oncology indications and geographies, were reviewed. Pain was triggered by disease symptoms and treatment, including surgical procedures, chemotherapy, and radiation. Pain was most often daily, severe, and chronic in nature. Characterizations of pain varied, but most often \u201csharp\u201d\/\u201cstabbing\u201d\/\u201cshooting\u201d pain was described across different treatment stages. Pain had an extensive impact on emotional wellbeing, activities of daily living, physical, physiological and social functioning, sleep and work. Unmet needs included difficulty communicating pain needs to healthcare practitioners and fear\/distrust of opioid pain medication. Conclusions: This research provides a patient-centric model conceptualizing the patient experience of cancer-related pain. The findings highlight the burden and all-encompassing impact of cancer-related pain, demonstrating the importance of assessing pain in oncology clinical trials.<\/jats:p>","DOI":"10.3390\/cancers17233760","type":"journal-article","created":{"date-parts":[[2025,11,25]],"date-time":"2025-11-25T10:46:18Z","timestamp":1764067578000},"page":"3760","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Pain Experience in Oncology: A Targeted Literature Review and Development of a Novel Patient-Centric Conceptual Model"],"prefix":"10.3390","volume":"17","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2278-2176","authenticated-orcid":false,"given":"Chloe","family":"Carmichael","sequence":"first","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-4737-0987","authenticated-orcid":false,"given":"Sophie","family":"Van Tomme","sequence":"additional","affiliation":[{"name":"Sanofi, 1105 BP Amsterdam, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jordan","family":"Miller","sequence":"additional","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5522-5384","authenticated-orcid":false,"given":"Danielle","family":"Burns","sequence":"additional","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8820-8822","authenticated-orcid":false,"given":"Cecile","family":"Gousset","sequence":"additional","affiliation":[{"name":"Sanofi, 94255 Gentilly, France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helen","family":"Kitchen","sequence":"additional","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-2205","authenticated-orcid":false,"given":"Harriet","family":"Makin","sequence":"additional","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natalie V. J.","family":"Aldhouse","sequence":"additional","affiliation":[{"name":"Clarivate Analytics, London EC3A 8BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Cordero","sequence":"additional","affiliation":[{"name":"Sanofi, Reading RG6 1PT, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,11,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1224","DOI":"10.1001\/jamaoncol.2019.1439","article-title":"Prevalence of chronic pain and high-impact chronic pain in cancer survivors in the United States","volume":"5","author":"Jiang","year":"2019","journal-title":"JAMA Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","unstructured":"Snijders, R.A.H., Brom, L., Theunissen, M., and van den Beuken-van Everdingen, M.H.J. (2023). Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers, 15.","DOI":"10.3390\/cancers15030591"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"487","DOI":"10.1111\/papr.13098","article-title":"Living systematic review to assess the analgesic undertreatment in cancer patients","volume":"22","author":"Roberto","year":"2022","journal-title":"Pain Pract."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"38","DOI":"10.1097\/j.pain.0000000000001363","article-title":"The IASP classification of chronic pain for ICD-11: Chronic cancer-related pain","volume":"160","author":"Bennett","year":"2019","journal-title":"Pain"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"865","DOI":"10.1016\/S1470-2045(09)70200-1","article-title":"Baseline quality of life as a prognostic indicator of survival: A meta-analysis of individual patient data from EORTC clinical trials","volume":"10","author":"Quinten","year":"2009","journal-title":"Lancet Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"3325","DOI":"10.1200\/JCO.2016.68.5206","article-title":"Management of Chronic Pain in Survivors of Adult Cancers: American Society of Clinical Oncology Clinical Practice Guideline","volume":"34","author":"Paice","year":"2016","journal-title":"J. Clin. Oncol."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"O\u015bmia\u0142owska, E., Misi\u0105g, W., Chabowski, M., and Jankowska-Pola\u0144ska, B. (2021). Coping Strategies, Pain, and Quality of Life in Patients with Breast Cancer. J. Clin. Med., 10.","DOI":"10.3390\/jcm10194469"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1177\/0194599818783964","article-title":"Pain in Head and Neck Cancer Survivors: Prevalence, Predictors, and Quality-of-Life Impact","volume":"159","author":"Cramer","year":"2018","journal-title":"Otolaryngol. Head Neck Surg."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Van den Beuken-van Everdingen, M.H.J., van Kuijk, S.M.J., Janssen, D.J.A., and Joosten, E.A.J. (2018). Treatment of Pain in Cancer: Towards Personalised Medicine. Cancers, 10.","DOI":"10.3390\/cancers10120502"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"6838","DOI":"10.3390\/curroncol30070500","article-title":"Cancer Pain Management: A Narrative Review of Current Concepts, Strategies, and Techniques","volume":"30","author":"Mestdagh","year":"2023","journal-title":"Curr. Oncol."},{"key":"ref_11","unstructured":"Food and Drug Administration (FDA) (2022). Patient-Focused Drug Development: Selecting, Developing, or Modifying Fit-for-Purpose Clinical Outcome Assessments. Guidance for Industry, Food and Drug Administration Staff, and Other Stakeholders, Food and Drug Administration. Draft Guidance."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1080\/07347332.2022.2074337","article-title":"\u201cFortunately I felt pain, or I would have thought I was on my way out\u201d: Experiencing pain and negotiating analgesic treatment in the context of cancer","volume":"41","author":"Restivo","year":"2023","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"129","DOI":"10.1007\/s40487-022-00219-y","article-title":"A Mixed-Methods Study to Better Measure Patient-Reported Pain and Fatigue in Soft Tissue Sarcoma","volume":"11","author":"Barrett","year":"2023","journal-title":"Oncol. Ther."},{"key":"ref_14","unstructured":"Critical Appraisal Skills Programme (2023, June 01). CASP Qualitative Checklist. Available online: https:\/\/casp-uk.net\/casp-checklists\/CASP-checklist-qualitative-2024.pdf."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"S423","DOI":"10.1016\/j.jval.2023.09.2212","article-title":"Qualitative Content Analysis for Concept Elicitation (CACE) in Clinical Outcome Assessment Development","volume":"26","author":"Carmichael","year":"2023","journal-title":"Value Health"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1277","DOI":"10.1177\/1049732305276687","article-title":"Three approaches to qualitative content analysis","volume":"15","author":"Hsieh","year":"2005","journal-title":"Qual. Health Res."},{"key":"ref_17","doi-asserted-by":"crossref","unstructured":"Lincoln, Y.S., and Guba, E.G. (1985). Naturalistic Inquiry, Sage.","DOI":"10.1016\/0147-1767(85)90062-8"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1136\/bmjspcare-2016-001232","article-title":"What are the current challenges of managing cancer pain and could digital technologies help?","volume":"8","author":"Adam","year":"2018","journal-title":"BMJ Support. Palliat. Care"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1105","DOI":"10.1177\/1460458217740724","article-title":"Understanding patient requirements for technology systems that support pain management in palliative care services: A qualitative study","volume":"25","author":"Allsop","year":"2019","journal-title":"Health Inform. J."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1080\/07347332.2017.1417949","article-title":"An interpretative phenomenological analysis of the experiences of older people self-managing cancer pain at home","volume":"36","author":"Appleyard","year":"2018","journal-title":"J. Psychosoc. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"311","DOI":"10.4236\/jct.2022.136027","article-title":"Experiences of Women Receiving Multifraction High Dose-Rate Brachytherapy for Cervical Cancer: A Prospective Qualitative Study","volume":"13","author":"Benali","year":"2022","journal-title":"J. Cancer Ther."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1275","DOI":"10.1080\/10428194.2023.2210711","article-title":"The experience of patients with acute myeloid leukemia in remission post-transplant","volume":"64","author":"Cella","year":"2023","journal-title":"Leuk. Lymphoma"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"753","DOI":"10.1016\/j.jpainsymman.2018.12.334","article-title":"Factors that hinder and facilitate cancer patients\u2019 knowledge about pain management\u2014A qualitative study","volume":"57","author":"Ekstedt","year":"2019","journal-title":"J. Pain Symptom Manag."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"414","DOI":"10.1016\/j.jopan.2022.06.007","article-title":"Perioperative Comfort and Discomfort: Transitioning From Epidural to Oral Pain Treatment After Pancreas Surgery: A Qualitative Study","volume":"38","author":"Englid","year":"2023","journal-title":"J. PeriAnesthesia Nurs."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"28","DOI":"10.1016\/j.ejon.2018.01.005","article-title":"Pain experiences of patients with advanced cancer: A qualitative descriptive study","volume":"33","author":"Erol","year":"2018","journal-title":"Eur. J. Oncol. Nurs."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"224","DOI":"10.1007\/s11764-020-00926-3","article-title":"The impact of scars on health-related quality of life after breast surgery: A qualitative exploration","volume":"15","author":"Everaars","year":"2021","journal-title":"J. Cancer Surviv."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1177\/08258597221149545","article-title":"Patients\u2019 Experiences of Cancer Pain: A Descriptive Qualitative Study","volume":"38","author":"Hassankhani","year":"2023","journal-title":"J. Palliat. Care"},{"key":"ref_28","doi-asserted-by":"crossref","unstructured":"Hodge, F.S., Line Itty, T., Arbing, R.H., and Samuel-Nakamura, C. (2022). A window into pain: American Indian cancer survivors\u2019 drawings. Front. Pain Res., 3.","DOI":"10.3389\/fpain.2022.1031347"},{"key":"ref_29","unstructured":"Koulouris, A. (2021). The Epidemiology of Abdominal Pain in Inoperable Pancreatic Cancer and the Potential Role of Early Endoscopic Ultrasound-Guided Coeliac Plexus Neurolysis. [Ph.D. Thesis, University of East Anglia]."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"506","DOI":"10.1016\/j.pmn.2017.11.006","article-title":"Breakthrough pain: A qualitative study of patients with advanced cancer in Northwest China","volume":"19","author":"Liu","year":"2018","journal-title":"Pain Manag. Nurs."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"72","DOI":"10.1016\/j.pmn.2017.11.007","article-title":"Experiences of urban African Americans with cancer pain","volume":"19","author":"Maly","year":"2018","journal-title":"Pain Manag. Nurs."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3233\/BLC-211518","article-title":"Qualitative analysis of pain in patients with locally advanced or metastatic urothelial carcinoma","volume":"8","author":"Martin","year":"2022","journal-title":"Bladder Cancer"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1285","DOI":"10.1007\/s11764-023-01370-9","article-title":"Perceptions of prescription opioids among marginalized patients with hematologic malignancies in the context of the opioid epidemic: A qualitative study","volume":"18","author":"Nabulsi","year":"2023","journal-title":"J. Cancer Surviv."},{"key":"ref_34","first-page":"78","article-title":"Managing Chronic Pain in Cancer Survivorship: Communication Challenges and Opportunities as Described by Cancer Survivors","volume":"41","author":"Fish","year":"2023","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"136","DOI":"10.1097\/NCC.0000000000000747","article-title":"The experience of complex pain dynamics in oncology outpatients: A longitudinal qualitative analysis","volume":"44","author":"Schumacher","year":"2021","journal-title":"Cancer Nurs."},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Smith, M.D., Manning, J., Nielsen, M., Hayes, S.C., Plinsinga, M.L., and Coppieters, M.W. (2023). Exploring women\u2019s experiences with persistent pain and pain management following breast cancer treatment: A qualitative study. Front. Pain Res., 4.","DOI":"10.3389\/fpain.2023.1095377"},{"key":"ref_37","doi-asserted-by":"crossref","unstructured":"Vestergaard, K., Vissing, M., Gehl, J., and Lindhardt, C.L. (2023). Qualitative investigation of experience and quality of life in patients treated with calcium electroporation for cutaneous metastases. Cancers, 15.","DOI":"10.3390\/cancers15030599"},{"key":"ref_38","first-page":"e13723","article-title":"Understanding pain related to adjuvant endocrine therapy after breast cancer: A qualitative report","volume":"31","author":"Walsh","year":"2022","journal-title":"Eur. J. Cancer Care"},{"key":"ref_39","first-page":"1169","article-title":"Discrepancy in the perception of symptoms among patients and healthcare providers after lung cancer surgery","volume":"30","author":"Wei","year":"2022","journal-title":"Support. Care Cancer"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"151216","DOI":"10.1016\/j.soncn.2021.151216","article-title":"The unique symptom burden of patients receiving CAR T-cell therapy","volume":"37","author":"Whisenant","year":"2021","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_41","first-page":"385","article-title":"Pain acceptance in cancer patients with chronic pain in Hunan, China: A qualitative study","volume":"6","author":"Xu","year":"2019","journal-title":"Int. J. Nurs. Sci."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.pmn.2017.10.017","article-title":"Living with symptoms: A qualitative study of black adults with advanced cancer living in poverty","volume":"19","author":"Yeager","year":"2018","journal-title":"Pain Manag. Nurs."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"E73","DOI":"10.1097\/NCC.0000000000001197","article-title":"A Qualitative Study of the Pain Experience of Black Individuals With Cancer Taking Long-Acting Opioids","volume":"47","author":"Yeager","year":"2023","journal-title":"Cancer Nurs."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"1305","DOI":"10.1007\/s11136-011-0054-x","article-title":"Implementing patient-reported outcomes assessment in clinical practice: A review of the options and considerations","volume":"21","author":"Snyder","year":"2012","journal-title":"Qual. Life Res."},{"key":"ref_45","unstructured":"Food and Drug Administration (FDA) (2024). Core Patient-Reported Outcomes in Cancer Clinical Trials: Guidance for Industry, Food and Drug Administration."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1016\/j.pain.2004.09.012","article-title":"Core outcome measures for chronic pain clinical trials: IMMPACT recommendations","volume":"113","author":"Dworkin","year":"2005","journal-title":"Pain"},{"key":"ref_47","unstructured":"US Food and Drug Administration (2024, February 14). Development of Non-Opioid Analgesics for Acute Pain: Guidance for Industry (Draft), Available online: https:\/\/www.fda.gov\/media\/156063\/download."},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"445","DOI":"10.1016\/j.medj.2022.06.007","article-title":"Patient-centered trials in oncology: Time for a change","volume":"3","author":"Araujo","year":"2022","journal-title":"Med"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/j.1526-4637.2008.00558.x","article-title":"Sex-based differences in pain perception and treatment","volume":"10","author":"Paller","year":"2009","journal-title":"Pain Med."}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/23\/3760\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,11,27]],"date-time":"2025-11-27T05:27:38Z","timestamp":1764221258000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/17\/23\/3760"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,11,25]]},"references-count":49,"journal-issue":{"issue":"23","published-online":{"date-parts":[[2025,12]]}},"alternative-id":["cancers17233760"],"URL":"https:\/\/doi.org\/10.3390\/cancers17233760","relation":{},"ISSN":["2072-6694"],"issn-type":[{"type":"electronic","value":"2072-6694"}],"subject":[],"published":{"date-parts":[[2025,11,25]]}}}