When I was growing up, cancer was almost always a terminal diagnosis. Thankfully today, according to the National Cancer Institute, more than 60 percent of people diagnosed with cancer will be alive in five years. That is certainly good news. However, the bad news is that one in five of those survivors will have chronic pain.
This revelation was the result of a new study by the University of Michigan Health System, published in the American Cancer Society’s journal Cancer, which showed that approximately 20% of cancer survivors at least two years post-diagnosis have current cancer-related chronic pain.
Study Design and Results
The study surveyed nearly 200 cancer survivors, of whom 31% were black and 49% were female. It analyzed the outcomes by pain status, race and sex.
Other study findings include:
- The most significant source of pain was cancer surgery (53.8%) for whites and cancer treatment (46.2%) for blacks.
- Women had increased pain, more pain flares, more disability due to pain, and were more depressed than men because of pain.
- Blacks with pain reported higher pain severity, expressed more concern about harmful pain treatment side effects, and had greater pain-related disability.
- 42.6% reported having pain since their diagnosis; 19.5% were currently experiencing pain.
The Future for Chronic Pain Cancer Survivors
As society ages, study authors say, pain complaints and cancer issues will grow as significant health concerns and health policy issues.
“All in all, the high prevalence of cancer and pain and now chronic cancer pain among these survivors, especially blacks and women, shows there’s more work to be done in improving the quality of care and research,” says lead study author and pain medicine specialist Carmen R. Green, M.D., professor of anesthesiology, obstetrics and gynecology and health management and policy at the University of Michigan.
Patient and physician knowledge and attitudes may lead to poor pain management, authors say. For instance, worries about side effects such as addiction or fears that pain is a sign that the cancer had gotten worse may lead patients and their doctors to minimize pain complaints.
“When necessary and appropriate there are a variety of therapies available to address pain and improve their well-being,” Green says.
Recommendations for Chronic Cancer-Related Pain
The American Cancer Society has some excellent recommendations for cancer patients experiencing pain.
- They stress that you have a right to ask for pain relief but acknowledge that some doctors don't know the best way to treat pain. In those cases, they encourage you to see a pain specialist.
- They also understand the difference between addiction and dependence and reassure patients that it is very rare for someone taking opioids for cancer-related pain to become addicted.
- Finally, they give the very good advice, “Pain is best relieved when treated early.” Too often, pain patients are urged to take as little medication as possible. The ACS recognizes that waiting until the pain is really bad will make it more difficult to control and will likely result in more medication being needed than if the pain was addressed when it first began.
If you'd like to learn more about controlling cancer-related chronic pain, see the ACS's section on Pain Control.
This study hit very close to home for me. Six years ago, at the age of 33, my son Chris was diagnosed with stage 3 melanoma, a deadly form of skin cancer. His doctors said they had never had anyone with that stage of melanoma survive more than two years. He then underwent a full year of interferon treatments, which his doctor described as “wicked.” I think Chris would agree. He spent the next year very sick and in a great deal of pain.
I can't begin to explain how thrilled I am to be able to tell you that Chris beat the odds and is still with us now, six years later! His tests continue to come back clear, with no evidence of any cancer. He has, however, been left with significant chronic pain problems. While I think he would tell you that he prefers the chronic pain to the alternative, it has had a major impact on his quality of life, leaving him unable to work at a normal full-time job. Chris is an incredibly brave and determined young man who doesn't complain. In fact, it was only recently when I pressed him about it that he admitted to me the full extent of his pain.
We are all so happy when someone survives cancer, I think we often forget about residual effects of the disease and its treatment – like chronic pain. Since anything related to cancer seems to get more attention from both the public and the medical community than other illnesses, I hope this study helps to make all more aware of chronic pain issues and the importance of taking pain seriously and treating it properly.
Cancer pain common among survivors, U-M study shows. University of Michigan Health System. Press release. January 13, 2011.
Green CR, et al. Cancer-related chronic pain: Examining quality of life in diverse cancer survivors. Cancer. 2011 May 1;117(9):1994-2003.
Facts about cancer pain treatment. American Cancer Society. Retrieved 4/29/11.
Published On: April 29, 2011