Analgesics Underused by Breast Cancer Patients

[Hopeful]

Elsevier Global Medical News. 2009 Oct 20, S Boschert

SAN FRANCISCO (EGMN) - Pain is common in breast cancer patients - painkillers less so, according to results of an online survey.

In all, 65% of 335 breast cancer patients reported they suffered from pain during the course of their disease or treatment, yet 28% of the 218 patients reporting pain did not use an analgesic.

The top reasons given for lack of analgesic use were not having a recommendation for analgesic use from their health provider (83%), fear of addiction or dependency (77%), and inability to pay for medication (74%), Dr. Charles B. Simone II and his associates reported in an award-winning poster at a breast cancer symposium sponsored by the American Society of Clinical Oncology.

Some of those who reported pain but no analgesic use tried physical therapy (86%), massage therapy (8%), or other alternative measures for pain control, but still reported having pain on a regular basis, said Dr. Simone, a clinical fellow at the National Cancer Institute's Radiation Oncology Branch.

The findings highlight a need for additional education of health care providers on cancer pain evaluation and management, the investigators suggested. Clinicians should make pain management a priority, perform a standardized assessment of pain at every oncology visit, and regularly discuss pain symptoms and pain treatment with breast cancer patients in order to break down the barriers to pain management, they suggested.

The survey was posted on the University of Pennsylvania's OncoLink Web site, the oldest and one of the largest online cancer information sources. Respondents were 97% female, 77% white, and predominantly educated beyond high school (82%).

Those who reported pain perceived it as being caused directly by cancer treatment (56%) or the cancer itself (40%), and 56% said they suffered from pain but were unsure of the cause. (Respondents could choose more than one of these categories.) Of the entire cohort, 92% had undergone surgery, 74% had been treated with chemotherapy, and 62% underwent radiation therapy.

Because 49% of those who reported pain said it primarily was intermittent and 39% described it as primarily chronic (instead of new pain or "other" categories), acute or inconsistent analgesic use may be inadequate. Many breast cancer patients could benefit from analgesic use throughout the course of their disease and treatment, Dr. Simone and his associates suggested.

Patients who reported pain were less likely to use analgesics if they did not undergo surgery and/or were more educated. Analgesic use was not significantly affected by type of treatment, race, or sex.

The investigators reported having no conflicts of interest related to the survey.

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