Public Defence: Morena Shkodra

MD Morena Shkodra at Institute of Clinical Medicine will be defending the thesis “Clinical assessment of cancer pain patients: focus on neuropathic pain” for the degree of PhD (Philosophiae Doctor).

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The public defence will be held as a video conference over Zoom.

The defence will follow regular procedure as far as possible, hence it will be open to the public and the audience can ask ex auditorio questions when invited to do so.

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Due to copyright issues, an electronic copy of the thesis must be ordered from the faculty. For the faculty to have time to process the order, the order must be received by the faculty at the latest 2 days before the public defence. Orders received later than 2 days before the defence will not be processed. After the public defence, please address any inquiries regarding the thesis to the candidate.

Trial Lecture – time and place

See Trial Lecture.

Adjudication committee

  • First opponent: Professor Rolf-Detlef Treede, Heidelberg University, Germany
  • Second opponent: Professor Sasha Gulati, Norwegian University of Science and Technology, Trondheim
  • Third member and chair of the evaluation committee: Associate Professor Hanne Cathrine Lie, University of Oslo

Chair of the Defence

Professor Emeritus Ulf Erik Kongsgaard, University of Oslo

Principal Supervisor

Stein Kaasa, University of Oslo

Summary

Cancer pain affects up to more than half of patients with advanced cancer disease, translating into impaired quality of life and an enormous social burden. Undertreatment remains frequent, reflecting partially the lack of standardized methods for the assessment and classification of cancer pain. This is particularly evident for neuropathic pain due to cancer, for which no widely agreed-upon diagnostic criteria are available.

The overall aim of this thesis was to contribute to an international classification system for cancer pain by improving the evidence for its clinical characterization through an in-depth assessment, identifying factors potentially predictive of analgesic response and validating a diagnostic algorithm for the standardization and improvement of NcP diagnosis.

We conducted two observational prospective studies, where patients with pain due to cancer of moderate to severe pain intensity were enrolled. Results emphasized the lack of a standardized way of assessing the presence of neuropathic cancer pain. Heterogeneity was encountered in its clinical assessment between different methods and clinicians, and an underestimation of the prevalence of neuropathic pain in cancer patients was found when using screening tools.

The involvement of specific tissues by the cancer lesion/s, translating into the presence of specific pain types, was demonstrated to be related to worse pain intensity during follow up. Additionally, a diagnostic algorithm, including simple clinical steps and instructions on how to perform a physical examination, was validated for the assessment of neuropathic cancer pain. The evaluation of cancer pain was enriched by the use of Quantitative Sensory Testing, providing a somatosensory profiling which demonstrated the presence of specific sensory alterations in patients with cancer pain. This could be used for patients’ stratification and to guide more personalized treatment approaches.

Additional information

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Published Apr. 9, 2024 1:18 PM - Last modified Apr. 22, 2024 10:57 AM