For cancer patients, pain can come from the
cancer itself, chronic inflammatory changes or infections. Standard cancer
treatments, such as surgery, chemotherapy and radiotherapy can also cause pain,
but despite its common occurrence, pain is a frequent source of patient anxiety
due to improper management.
Researchers at the University of
Pennsylvania Department of Radiation Oncology in Philadelphia and
the Radiation Oncology Branch of the National Cancer Institute in Bethesda, Md., sought to
determine the main reasons that patients fail to receive optimal pain therapy.
Between November 2005 and April 2006, 106
radiation therapy patients responded to an Internet-based questionnaire that
evaluated their medication use, pain control and attitudes toward pain
medication, including prescription and over-the-counter pain medications.
Fifty-eight percent reported pain from their cancer treatment and 46 percent of
patients reported pain directly from their cancer, yet 80 percent of those
patients said that they did not use medication to manage their pain.
Most patients said the main reason they did
not take pain medication was because their healthcare provider did not
recommend it. This reason was followed by a fear of addiction or dependence and
the inability to pay. Some patients also reported using alternative therapies
for pain relief, including physical therapy, massage and acupuncture.
"To eliminate barriers to optimal pain
management for cancer patients, healthcare providers should talk with their
patients about pain symptoms and pain medications," Charles Simone, M.D., a
resident at the National Cancer Institute Radiation Oncology Branch in Bethesda, Md. and lead
author of the study, said.
"At our institution we have taken these
steps by transitioning to an electronic medical record system that has been
designed to require an evaluation and documentation of patient pain levels and
pain medication responses by healthcare providers at each patient encounter."