Vol.:(0123456789) 1 3 Clinical and Translational Oncology https://doi.org/10.1007/s12094-017-1826-8 RESEARCH ARTICLE A survey of perceptions, attitudes, knowledge and practices of medical oncologists about cancer pain management in Spain Jesús García‑Mata 1  · Cecilio Álamo 2  · Javier de Castro 3  · Jorge Contreras 4  · Rafael Gálvez 5  · Carlos Jara 6  · Antonio Llombart 7  · Concepción Pérez 8  · Pedro Sánchez 9  · Susana Traseira 10  · Juan‑Jesús Cruz 11 Received: 15 December 2017 / Accepted: 23 December 2017 © Federación de Sociedades Españolas de Oncología (FESEO) 2018 Abstract Purpose To monitor oncologists’ perspective on cancer pain management. Methods An anonymized survey was conducted in two waves. First, over a convenience sample of oncologists known to be particularly concerned with the management of pain. Second, using a random sample of oncologists. Results In total, 73 and 82 oncologists participated in the frst and second wave, respectively. Many oncologists reported to have good knowledge of analgesic drugs (95.9%), the mechanism of action of opioids (79.5%), and good skills to manage opioid-related bowel dysfunction (76.7%). Appropriate adjustment of background medication to manage breakthrough pain was reported by 95.5% of oncologists. Additionally, 87.7% (68.3% in the second wave, p = 0.035) of oncologists reported suitable opioid titration practices, and 90.4% reported to use co-adjuvant medications for neuropathic pain confdently. On the other hand, just 9.6% of oncologists participated in multidisciplinary pain management teams, and merely 30.3 and 27.1% reported to routinely collaborate with the Pain Clinics or involve other staf, respectively. Only 26.4% of the oncologists of the second wave gave priority to pain pathophysiology to decide therapies, and up to 75.6% reported difculties in treating neuropathic pain. Signifcantly less oncologists of the second wave (82.9 vs. 94.5%, p = 0.001) used opioid rotation routinely. Conclusions Unlike in previous surveys, medical oncologists reported in general good knowledge and few perceived limita- tions and barriers for pain management. However, multi-disciplinary management and collaboration with other specialists are still uncommon. Oncologists’ commitment to optimize pain management seems important to improve and maintain good practices. Keywords Clinical oncology · Surveys and questionnaires · Medical education · Chronic pain · Opioid analgesics · Delivery of health care * Juan-Jesús Cruz jjcruz@usal.es 1 Medical Oncology Department, Santa María Nai Hospital, Orense, Spain 2 Department of Pharmacology, University of Alcalá de Henares, Madrid, Spain 3 Medical Oncology Department, La Paz Hospital, Madrid, Spain 4 Radiotherapeutic Oncology Department, Carlos Haya Hospital, Málaga, Spain 5 Pain Clinic and Palliative Care Unit, Virgen de las Nieves Hospital, Granada, Spain 6 Medical Oncology Department, Alcorcón Hospital, Madrid, Spain 7 Medical Oncology Department, Arnau de Vilanova Hospital, Valencia, Spain 8 Pain Clinic, La Princesa Hospital, Madrid, Spain 9 Medical Oncology Department, Specialty Hospital, Jaén, Spain 10 Medical Department, Mundipharma Pharmaceuticals, Madrid, Spain 11 Hospital Universitario de Salamanca-Universidad de Salamanca (USAL), Instituto de Investigación Biomédica de Salamanca (IBSAL), Salamanca, Spain