Chapter 10 : Care of the Dying

Section 5. Case Study

Docs Treat Cancer, but Not Its Pain, Study Shows

Docs Treat Cancer, but Not Its Pain, Study Shows


July 18, 2002

Washington - Cancer patients often suffer needlessly because the nation's medical system does a poor job of treating pain that is a common part of the disease, according to experts who produced a study for the National Institutes of Health.

"Cancer-related pain, depression and fatigue are undertreated and this situation is simply unacceptable," said Dr. Donald Patrick, a medical professor at the University of Washington, Seattle, and chairman of the committee.

"We have to move to the point that patient comfort and care are a part of the cancer treatment agenda," said Dr. Andrew T. Turrisi III, a radiation oncologist at the Medical University of South Carolina, Charleston. "Some patients are more fearful of pain than they are of death itself."

The report was written after the 13-member panel analyzed a series of studies. "Optimal pain relief for cancer patients needs to be a minimally accepted standard," the committee statement said. "Inadequately treated pain can be considered one indicator of poor quality of care."

Patrick said the group found many doctors don't know how to control relentless pain and medical schools fail to provide adequate training in pain management.

There are also bureaucratic barriers, the panel said. Committee member Dr. Paul S. Frame, a professor at the University of Rochester, N.Y., School of Medicine, said some government regulations require a three- copy report each time a doctor prescribes opiates.

"Sometimes practitioners don't want to go to the hassle of prescribing a triplicate drug," he said. "They may use something less effective instead."

The committee said studies have estimated from 14 to 100 percent of cancer patients have relentless pain. The most common estimates found pain poorly controlled in 26 to 41 percent of patients. One obstacle is that patients often give doctors poor insight into their pain, some believing it must be tolerated. Others have an unrealistic fear about opiates and often choose to suffer instead of asking for the drugs, he said.

Copyright 2002, Newsday, Inc.

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Copyright Philip A. Pecorino 2002. All Rights reserved.

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