MASCC recommendations on the management of constipation in patients with advanced cancer

  • Andrew DaviesEmail author
  • Charlotte Leach
  • Ricardo Caponero
  • Andrew Dickman
  • David Fuchs
  • Judith Paice
  • Anton Emmanuel
Review Article



The Palliative Care Study Group of the Multinational Association for Supportive Care in Cancer formed a subgroup to develop evidence-based recommendations on the management of constipation in patients with advanced cancer.


These recommendations were developed in accordance with the MASCC Guidelines Policy. A search strategy for Medline was developed, and the Cochrane Database of Systematic Reviews and the Cochrane Central Register of Controlled Trials were explored for relevant reviews/trials respectively. The recommendations were categorised by the level of evidence and a “category of guideline” based on the level of evidence (i.e. “recommendation”, “suggestion”, or “no guideline possible”).


The group produced 15 recommendations, with varying levels of evidence and so varying categories of guideline. The recommendations relate to the assessment, the treatment, and the re-assessment of constipation.


These recommendations provide a framework for the management of constipation in advanced cancer, although every patient needs individualised management.


Constipation Neoplasms Palliative care Practice guideline 


Compliance with ethical standards

Conflict of interest

ADavies has received personal fees and research funding from Kyowa Kirin; CL has received personal fees from Kyowa Kirin; ADickman has received personal fees from Kyowa Kirin; DF has received personal fees from Novartis, Pfizer, and Roche.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Royal Surrey County HospitalGuildfordUK
  2. 2.Hospital Alemão Oswaldo CruzSão PauloBrazil
  3. 3.Royal Liverpool HospitalLiverpoolUK
  4. 4.Kepler University HospitalLinzAustria
  5. 5.Northwestern UniversityChicagoUSA
  6. 6.University College London HospitalsLondonUK

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