Cancer Research - Europa

EPCRC
The European Palliative Care Research
Collaborative: improved treatment of
pain, depression and fatigue through
translation research
Summary
Keywords | Cancer | palliative care | pain | depression | fatigue | cachexia | opioid response | genetic marker |
classifi cation | assessment | guidelines |
Pain, depression and fatigue are subjective clinical manifestations
of advanced cancer. Control of these symptoms is
pivotal for the quality of life of millions of palliative care
patients. Pain is the most feared symptom for many patients.
The prevalence of depression varies from 6-58 % in palliative
care patients, refl ecting lack of a standardised validated
methodology for its assessment in these patients.
Cachexia is likely to be the most important contributor to
fatigue in palliative care. The plethora of other symptoms,
co-morbidities, and the advanced age of most palliative
patients support the need for evidence-based management
strategies. To improve management of pain, depression and
cachexia in cancer patients demands new knowledge
through research in several areas.
The research plan of the EPCRC will be based upon questions
raised in a clinical setting, with focus on palliative care
cancer patients, thus a ‘true’ translational approach is chosen.
The research will focus both on diagnosis and
classifi cation of these symptoms and on an understanding
of the underlying mechanisms. To reach the aims of EPCRC
requires a multidisciplinary approach, including basic scientists
and clinicians who will translate human genome data
into practical applications for these patients.
Assessment and classifi cation of pain, depression and
cachexia (fatigue) are the basis for diagnosis and subsequent
treatment. By use of modern molecular biology
methods in this project, we will increase the understanding
of the role of genetic variability for pain and cachexia. European
evidence-based Internet guidelines will be developed
by members of the EPCRC, supported by an international
advisory board. By recruiting a pan-European panel, cultural,
social and language barriers will be taken into consideration
in the early phase of guideline development.
Problem
Even though pain, fatigue and depressive symptoms are the
most common symptoms in advanced cancer, there is still
inadequate understanding of the inter-individual variability
of these problems. Cachexia is a major reason for fatigue in
palliative care patients, but there is no internationally agreed
assessment tool or classifi cation system for either cachexia
or depression in this patient group. Although there are several
publications and agreements on the classifi cation of
pain, there is still no consensus on how to assess or measure it.
In addition, there is a lack of internationally developed
and updated clinical guidelines for the treatment of these
conditions and symptoms.
Aim
The overall objectives are to develop novel genetic methods
for prediction of opioid responses and individual variation of
fatigue (cachexia), and methods for assessment and classifi
cation of pain, fatigue (cachexia), and depression.
• To identify genes and genetic variation relevant for interindividual
variation in opioid responses and genetic
variation that may identify patients at particular risk for
developing cachexia.
• To improve classifi cation and assessment of pain, depression
and cachexia by computer-assisted approaches.
• To combine the new knowledge of symptoms, genomics
and assessment in an Internet-based system for implementation
of European evidence-based guidelines, which
will include standardised assessment and individualised
treatment plans for pain, depression and cachexia.
• To develop a long lasting European Collaborative in
palliative care cancer research.
234 CANCER RESEARCH PROJECTS FUNDED UNDER THE SIXTH FRAMEWORK PROGRAMME