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ORIGINAL RESEARCH ARTICLE

Pain characteristics of adult hematological cancer patients at an outpatient clinic in Nigeria: A cross-sectional study

Ogochukwu Izuegbuna1* ,  Oyewale Saburi2 ,  Chijioke Adindu2 ,  Tiwalade Woods-Ali3 ,  Saliu Oguntola4 ,  Israel Kolawole3
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1 Department of Haematology and Blood Transfusion, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State , Nigeria
2 Department of Surgery, University of Ilorin Teaching Hospital, Ilorin, Kwara State , Nigeria
3 Department of Anesthesia, University of Ilorin Teaching Hospital, Ilorin, Kwara State , Nigeria
4 Department of Surgery, Ladoke Akintola University of Technology Teaching Hospital, Ogbomoso, Oyo State , Nigeria
CP, 026260041 https://doi.org/10.36922/CP026260041
Received: 28 June 2026 | Revised: 26 August 2026 | Accepted: 10 September 2026 | Published online: 23 September 2026
© 2026 by the Author(s). This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution 4.0 International License ( https://creativecommons.org/licenses/by/4.0/ )
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Abstract

Pain is a very common complaint among hematological cancer patients. There has yet to be a study on the portrayal of pain experiences among hematological cancer patients in Nigeria. This study primarily aims to appraise the clinical characteristics of pain issues in Nigerian hematological cancer patients. The 36 hematological cancer patients from the University of Ilorin Teaching Hospital were divided into myeloma and non-myeloma groups. Their socio-demographics and clinical attributes were recorded. The PainDETECT Questionnaire, numeric pain rating scale, and Pain Management Index (PMI) were used to evaluate their pain levels. Approximately 67% of study participants complained of pain at presentation, and 92% reported it as their worst in the past four weeks. The mean participant age was 58 years. Multiple myeloma was significantly associated with age (p = 0.035), performance status (p = 0.044), pain at presentation (p = 0.047), worst pain in four weeks (p = 0.013), and neuropathic pain (p < 0.001). Due to the small sample size (n = 36), these associations are exploratory and hypothesis-generating. The percentage of patients receiving inadequate pain therapy (PMI < 0) was 22.2%. This research shows the characteristics of pain in hematological cancer patients in Nigeria. The findings highlight the unevenly higher frequency of neuropathic pain in multiple myeloma compared to other hematological cancers. In addition, the study exposed inadequate pain management.

Keywords
Hematological cancer
Multiple myeloma
Cancer pain
Neuropathic pain
Pain management index
Funding
None.
Conflict of interest
The authors have no conflicts of interest to declare.
References
  1. Bray F, Laversanne M, Sung H, et al. Global cancer statistics 2022: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2024;74(3):229-263. doi: 10.3322/caac.21834
  2. Okello CD, Niyonzima N, Ferraresso M, et al. Haematological malignancies in sub-Saharan Africa: east Africa as an example for improving care. Lancet Haematol. 2021;8(10):e756-e769. doi: 10.1016/S2352-3026(21)00198-8
  3. Mulatie Z, Berta DM, Gedefie A, et al. Prevalence of hematological malignancies in Africa: a systematic review and meta-analysis. Sci Rep. 2025;15:9471. doi: 10.1038/s41598-025-94428-w
  4. Geyer HL, Gazelka H, Mesa R. How I treat pain in hematologic malignancies safely with opioid therapy. Blood. 2020;135(26):2354-2364. doi: 10.1182/blood.2019003116
  5. Kibret AA, Wolde HF, Moges AM, et al. Prevalence and associated factors of cancer pain among adult cancer patients evaluated at an oncology unit in the University of Gondar Comprehensive Specialized Hospital, northwest Ethiopia. Front Pain Res. 2023;3:1061239. doi: 10.3389/fpain.2022.1061239
  6. Bandieri E, Sichetti D, Luppi M, et al. Is pain in patients with haematological malignancies under-recognised? The results from Italian ECAD-O survey. Leuk Res. 2010;34(12):e334-e335. doi: 10.1016/j.leukres.2010.08.013
  7. World Health Organization. Cancer Pain Relief: With a Guide to Opioid Availability. 2nd ed. World Health Organization; 1996. Accessed September 10, 2026. https://iris.who.int/handle/10665/37896
  8. Thronæs M, Balstad TR, Brunelli C, et al. Pain management index (PMI)—does it reflect cancer patients’ wish for focus on pain? Support Care Cancer. 2020;28(4):1675-1684. doi: 10.1007/s00520-019-04981-0
  9. Joseph AO, Salako O, Alabi A, et al. Cancer pain control in a Nigerian oncology clinic: treating the disease and not the patient. Pan Afr Med J. 2021;40:104. doi: 10.11604/pamj.2021.40.104.25225
  10. Nuhu FT, Odejide OA, Adebayo KO, Yusuf AJ. Psychological and physical effects of pain on cancer patients in Ibadan, Nigeria. Afr J Psychiatry. 2009;12(1):64-70. doi: 10.4314/ajpsy.v12i1.30281
  11. Izuegbuna O, Kolawole I, Oguntola S, et al. Prevalence and factors associated with cancer-related neuropathic pain among cancer patients in Nigeria—a single-center cross-sectional study. Pain Manag. 2025;15(5):251-258. doi: 10.1080/17581869.2025.2494978
  12. Jones KR, Vojir CP, Hutt E, et al. Determining mild, moderate, and severe pain equivalency across pain-intensity tools in nursing home residents. J Rehabil Res Dev. 2007;44(2):305-314. doi: 10.1682/jrrd.2006.05.0051
  13. Diaz-delCastillo M, Chantry AD, Lawson MA, Heegaard AM. Multiple myeloma—a painful disease of the bone marrow. Semin Cell Dev Biol. 2021;112:49-58. doi: 10.1016/j.semcdb.2020.10.006
  14. Shen WC, Chen JS, Shao YY, et al. Impact of undertreatment of cancer pain with analgesic drugs on patient outcomes: a nationwide survey of outpatient cancer patient care in Taiwan. J Pain Symptom Manage 2017;54(1):55-65.e1. doi: 10.1016/j.jpainsymman.2017.02.018
  15. Niscola P, Cartoni C, Romani C, et al. Epidemiology, features and outcome of pain in patients with advanced hematological malignancies followed in a home care program: an Italian survey. Ann Hematol. 2007;86(9):671-676. doi: 10.1007/s00277-007-0296-4
  16. Niscola P, Romani C, Cartoni C, et al. Epidemiology of pain in hospital haematological setting: an Italian survey. Leuk Res. 2008;32(1):197-198. doi: 10.1016/j.leukres.2007.03.024
  17. Costantini M, Ripamonti C, Beccaro M, et al. Prevalence, distress, management, and relief of pain during the last 3 months of cancer patients’ life. Results of an Italian mortality follow-back survey. Ann Oncol. 2009;20(4):729-735. doi: 10.1093/annonc/mdn700
  18. Stalfelt AM, Brodin H, Pettersson S, Eklöf A. The final phase in acute myeloid leukaemia (AML). A study on bleeding, infection and pain. Leuk Res. 2003;27(6):481-488. doi: 10.1016/s0145-2126(02)00262-x
  19. Ramsenthaler C, Kane P, Gao W, et al. Prevalence of symptoms in patients with multiple myeloma: a systematic review and meta-analysis. Eur J Haematol. 2016;97(5):416-429. doi: 10.1111/ejh.12790
  20. Zeng L, Huang H, Liu Y, et al. The core symptom in multiple myeloma patients undergoing chemotherapy: a network analysis. Support Care Cancer. 2023;31(5):297. doi: 10.1007/s00520-023-07759-7
  21. Nwabuko OC, Igbigbi EE, Chukwuonye II, Nnoli MA. Multiple myeloma in Niger Delta, Nigeria: complications and the outcome of palliative interventions. Cancer Manag Res. 2017;9:189-196. doi: 10.2147/CMAR.S126136
  22. Nnonyelum ON, Anazoeze MJ, Eunice NO, et al. Multiple myeloma in Nigeria: a multi-centre epidemiological and biomedical study. Pan Afr Med J. 2015;22:292. doi: 10.11604/pamj.2015.22.292.7774
  23. Jespersen E, Nielsen LK, Larsen RF, Möller S, Jarlbæk L. Everyday living with pain—reported by patients with multiple myeloma. Scand J Pain. 2021;21(1):127-134. doi: 10.1515/sjpain-2020-0087
  24. Bilińska M, Usnarska-Zubkiewicz L, Pokryszko-Dragan A. Bortezomib-induced painful neuropathy in patients with multiple myeloma. Contemp Oncol. 2013;17(5):421-426. doi: 10.5114/wo.2013.37214
  25. Yang Y, Zhao B, Lan H, Sun J, Wei G. Bortezomib-induced peripheral neuropathy: clinical features, molecular basis, and therapeutic approach. Crit Rev Oncol Hematol. 2024;197:104353. doi: 10.1016/j.critrevonc.2024.104353
  26. Argyriou AA, Iconomou G, Kalofonos HP. Bortezomib-induced peripheral neuropathy in multiple myeloma: a comprehensive review of the literature. Blood. 2008;112(5):1593-1599. doi: 10.1182/blood-2008-04-149385
  27. Strifler S, Knop S. The role of carfilzomib in treatment of newly diagnosed multiple myeloma. Future Oncol. 2018;14(30):3123-3134. doi: 10.2217/fon-2018-0040
  28. Expósito Vizcaíno S, Casanova-Mollà J, Escoda L, Galán S, Miró J. Neuropathic pain in cancer patients treated with bortezomib. Neurologia. 2018;33(1):28-34. [In Spanish]. doi: 10.1016/j.nrl.2016.05.008
  29. Ito T, Handa H. Molecular mechanisms of thalidomide and its derivatives. Proc Jpn Acad Ser B Phys Biol Sci. 2020;96(6):189-203. doi: 10.2183/pjab.96.016
  30. Banach M, Jurczyszyn A, Skotnicki A. Polekowa neuropatia obwodowa u pacjentów ze szpiczakiem plazmocytowym leczonych talidomidem [Thalidomide induced peripheral neuropathy in multiple myeloma patients]. Przegl Lek. 2015;72(11):629-635. [In Polish]
  31. Morawska M, Grzasko N, Kostyra M, Wojciechowicz J, Hus M. Therapy-related peripheral neuropathy in multiple myeloma patients. Hematol Oncol. 2015;33(4):113-119. doi: 10.1002/hon.2149
  32. Sichetti D, Bandieri E, Romero M, et al; ECAD Working Group. Impact of setting of care on pain management in patients with cancer: a multicentre cross-sectional study. Ann Oncol. 2010;21(10):2088-2093. doi: 10.1093/annonc/mdq155
  33. Fujii A, Yamada Y, Takayama K, et al. Longitudinal assessment of pain management with the pain management index in cancer outpatients receiving chemotherapy. Support Care Cancer. 2017;25(3):925-932. doi: 10.1007/s00520-016-3482-x
  34. Donati CM, Zamagni A, Zamfir AA, et al. Exploring pain management in breast cancer: key findings from the ARISE study. Front Oncol. 2025;15:1536709. doi: 10.3389/fonc.2025.1536709
  35. Shrestha S, Sapkota S, Teoh SL, et al. Comprehensive assessment of pain characteristics, quality of life, and pain management in cancer patients: a multi-center cross-sectional study. Qual Life Res. 2024;33(10):2755-2771. doi: 10.1007/s11136-024-03725-w
  36. Greco MT, Roberto A, Corli O, et al. Quality of cancer pain management: an update of a systematic review of undertreatment of patients with cancer. J Clin Oncol. 2014;32(36):4149-4154. doi: 10.1200/JCO.2014.56.0383
  37. Apolone G, Corli O, Caraceni A, et al.; Cancer Pain Outcome Research Study Group (CPOR SG) Investigators. Pattern and quality of care of cancer pain management. Results from the Cancer Pain Outcome Research Study Group. Br J Cancer. 2009;100(10):1566-1574. doi: 10.1038/sj.bjc.6605053
  38. Yu C, Cai T, Zhou T, et al. Classification of symptom subtypes in patients with multiple myeloma during treatment: a cross-sectional survey study in China. BMJ Open. 2023;13(3):e066467. doi: 10.1136/bmjopen-2022-066467
  39. Niscola P, Tendas A, Scaramucci L, Giovannini M, De Sanctis V. Pain in blood cancers. Indian J Palliat Care. 2011;17(3):175-183. doi: 10.4103/0973-1075.92333
  40. Paice JA, Moreira J. Pain syndromes of hematologic malignancies. In: Ullrich CK, Roeland EJ, eds. Palliative Care in Hematologic Malignancies and Serious Blood Disorders. Springer; 2023:153-167. doi: 10.1007/978-3-031-38058-7_13
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Cancer Plus, Electronic ISSN: 2661-3840 Print ISSN: 2661-3832, Published by AccScience Publishing
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