Physician Attitudes and Practice in Cancer Pain Management: A Survey From the Eastern Cooperative Oncology Group

Abstract

Professional education needs to focus on the proper assessment of pain, focus on the management of side effects, and focus on the use of adjuvant medications. A better understanding of the pharmacology of opioid analgesics is also needed. Physicians also need to educate patients to report pain and to effectively use the medications that are prescribed for pain management.

Cancer Pain Prevalence and its Management

“…The problems encountered at this subject can be summarized as insufficient knowledge and experience of healthcare professionals in relation to pain assessment and treatment, and as their being indifferent to patient's pain (Van den Beuken-van Everdingen et al, 2007;Oldenmenger et al, 2009). It has been reported that 57 to 76% of medical oncologists do not inquire about patient's pain, and in another study it has been shown that 55% of patients try to retain his/her pain on the agenda by constantly reminding their doctors their pain (Von Roenn et al, 1993;Breivik et al, 2009). …”

Trends in opioid use for chronic neuropathic pain: a survey of patients pursuing enrollment in clinical trials

“…In particular, patients' and physicians' denial of pain have been previously identified as possible causes for pain to go untreated. 18,23 With the example of diabetic neuropathic pain, symptoms tend to develop more slowly than peripheral nerve deterioration 24 and this insidious progression may make patients more likely to accept pain as part of their chronic illness. Also, this study group represents older patients (especially those with postherpetic neuralgia) who have been observed to complain less about existing pain.…”

Cancer-related pain management in clinical oncology

“…76 Single fraction radiation is recommended over multiple-fraction regimens for the treatment of metastatic bone pain. 77 Tere is no diference in the duration of or time to pain relief between single large fraction radiation and conventional radiation treatments involving mul- 86 tiple fractions; however, there is a higher retreatment rate in single fraction radiation. 78 Patients should also be aware of a possible transient increase in pain at the treatment site, which may be decreased with NSAIDs or corticosteroids.…”

“…A study that surveyed physicians found that 76% of physicians identifed poor pain assessment as the single most important barrier to adequate pain management. 20 An efective cancer pain assessment identifes underlying pain syndromes and mechanisms to develop the most efective treatment plan for pain control. An efective pain assessment is predicated on a trusting physicianpatient relationship and includes a detailed medical and pain history, physical exam, psychosocial and spiritual evaluation, and screen for substance abuse.…”