Pain Information for Professionals

A priority of the American Cancer Society is to provide adequate pain and symptom control as essential to improving quality of life. Pain is a major health problem in the United States, especially the kind of pain that is often experienced by individuals with cancer.

A diagnosis of cancer may trigger common emotions of fear, anxiety, sadness, confusion and feelings of depression and helplessness. When pain is severe, these emotions are exacerbated and may lead to despair and life may not seem worth living. It can interfere with day-to-day activities and diminish a person’s physical, psychological, and interpersonal well-being. The treatment and management of pain and its accompanying symptoms must be improved significantly.

The American Cancer Society believes that the inadequate treatment of pain is a significant public health problem in the United States.

  • Approximately 50 to 70 percent of cancer patients experience uncontrolled pain at some point during their illness, depending on the stage of the disease.1
  • Research indicates that over 40 percent of patients with cancer do not get adequate relief of their pain in spite of the fact that medications and other therapies currently exist to relieve almost all cancer pain.2
  • Pain is one of the most common and most feared symptoms of cancer. The perception that pain is associated with cancer makes it the most feared disease by Americans.
  • Under-treatment of pain has significant adverse effects on quality of life and has been associated with serious patient despair and depression.

Significant disparities exist in the treatment of pain. Special populations, including racial minorities, children, and the elderly in particular face difficulty accessing effective pain management. Additionally, the medical treatment of pain often fails to address the cultural differences of cancer patients.

  • The New England Journal of Medicine reported that black Americans receive inferior medical care for pain, even if they are on equal economic footing with whites.3
  • Pharmacies in both predominately nonwhite and in many rural communities often carry inadequate stocks of opioids. This results in many patients having difficulties obtaining medications for appropriate pain relief.
  • Nearly one third of children’s cancer centers in North America did not use general anesthesia or deep sedation for the majority of bone marrow procedures, and more than 25 percent used either nothing or topical anesthesia.4
  • Research has found that elderly and female patients are more likely to be undertreated for their cancer pain.5

Today’s science is strong enough that the majority of individuals with cancer pain can indeed find relief by using current drugs and other types of pain relief techniques. Cancer patients need not suffer from cancer pain. In fact, when cancer pain is controlled, patients and their providers can dedicate more energy to fighting the cancer. For those individuals who remain in pain despite the application of standard treatment regimens, additional consultation with experts in the field should be sought.

 

Pain Management Resources for Professionals

American Cancer Society resources

American Alliance of Cancer Pain Initiatives (AACPI)
This is a national network of state-based pain initiatives.

The American Pain Society
The American Pain Society is a multidisciplinary organization of basic and clinical scientists, practicing clinicians, policy analysts, and others. The mission of the American Pain Society is to advance pain-related research, education, treatment and professional practice.

Beth Israel Medical Center: Department of Pain Management and Palliative Care
The Department of Pain Medicine and Palliative Care is dedicated to providing comprehensive care of the highest quality in pain management and palliative care, and advancing the educational and research aims of these disciplines.

City of Hope Pain/Palliative Care Resource Center
The COHPPRC is a central source for collecting a variety of materials including pain assessment tools, patient education materials, quality assurance materials, end of life resources, research instruments and other resources

Professional Organizations

American Society for Pain Management Nurses (ASPMN)
This organization of professional nurses is dedicated to promoting and providing optimal care of individuals with pain, including the management of its sequelae. This is accomplished through education, standards, advocacy, and research.

American Academy of Pain Management
This group credentials multidisciplinary pain practitioners.

American Board of Pain Medicine
This board credentials qualified physicians in the field of pain medicine.

American Board of Hospice and Palliative Medicine
This board credentials physicians practicing hospice and palliative medicine.

Hospice and Palliative Nurses Association
The purpose of the Hospice and Palliative Nurses Association (HPNA) is to exchange information, experiences, and ideas; to promote understanding of the specialties of hospice and palliative nursing; and to study and promote hospice and palliative nursing research.

 

Pain & Public Policy

Pain & Policy Studies Group, University of Wisconsin Comprehensive Cancer Center
This group facilitates public access to information about pain relief and public policy.

Pain and the Law, Saint Louis University and the American Society of Law, Medicine & Ethics

Footnotes
1. Foley, KM. “The Treatment of Cancer Pain.” New England Journal of Medicine, 1985, 313:84-95; Cleeland, CS, Gonin R, Hatfield, AK, et. al. “Pain and Its Treatment in Outpatients with Metastatic Cancer.” New England Journal of Medicine, 1994, 330:592-596.
2. Cleeland, ibid.
3. Freeman, HP and Payne, R. “Racial Injustice in Health Care,” New England Journal of Medicine, 2000, 342.
4. Wolfe J., Grier HE, Klar N., et. al. “Symptoms and Suffering at the End of Life in Children with Cancer.” New England Journal of Medicine, 2000, 342:326-333.
5. Cleeland, ibid.