Opioid Treatment for Cancer vs. Non-Cancer Pain: Is There Really a Difference?
To hurt, or not to hurt--that is the question:
Whether 'tis nobler in the mind to relieve
The pain and suffering of cancer patients
Than to take action against a sea of non-cancer pain
And by treating, end the suffering.
With apologies to Mr. William Shakespeare, I couldn't resist using the format of Hamlet's Soliloquy to make a point about the difference in attitude government regulators, medical professionals and the general public have when it comes to using opioids to treat cancer vs non-cancer pain.
There seems to be this feeling that the pain of cancer patients is more honorable or noble that that of patients whose pain is caused by other diseases, conditions or injuries. As such, it is deemed more acceptable to treat cancer patients with as much opioid medication as necessary to relieve their pain. In fact, some of the stronger opioid medications are only approved for the treatment of cancer pain. It doesn't matter if your pain is just as severe as that of someone with cancer. According to the FDA, you don't deserve the same degree of pain relief as someone with a malignancy.
A Little Background
To a certain extent, I can understand how this attitude developed. I remember not so many years ago when a cancer diagnosis was almost always a death sentence. Despite the fact that today approximately 66% of people diagnosed with cancer are still alive more than five years after their diagnosis, and some types of cancer are even considered to be curable, the word "cancer" is still synonymous with death to many people. Cancer remains one of the most feared diagnoses anyone can receive.
I can also still remember very clearly when doctors would refuse to give opioids even to terminal cancer patients because they were afraid of them becoming addicted. I always thought that was ridiculous. If a person only has six months to live, who cares if they become addicted. It seemed more important to me to keep them as comfortable as possible for the time they had left. Thankfully the medical profession has come to agree with that thinking.
That's where I think the idea of giving cancer a special place when it comes to treating pain probably began. It was acceptable to relieve someone's pain if they weren't going to live much longer. And even though now many more cancer patients are going on to live long lives, the cancer diagnosis still gets special treatment when it comes to pain.
In My Opinion...
I absolutely believe cancer patients should receive whatever pain medication they need to ease their suffering. But what about those of us who have non-cancer pain? Is our pain any less severe because it is not caused by cancer? I don't think so--and neither does pain specialist Lynn R Webster, MD.
Dr. Webster is cofounder of LifeSource, a non-profit foundation that provides education about pain-related issues, as well as funding and conducting research. In a recent blog, writing about non-cancer vs cancer pain, he said, "Cancer or cancer therapy can cause tissue injury. But is the tissue or injured nervous system caused by cancer different than that caused by trauma, diabetes, shingles, or arthritis? No. There is no valid scientific explanation for the separation. Pain is pain."
I couldn't agree more. Pain is pain. The cause of the pain is far less important than the effect it has on our lives. I think it's time the medical profession, the government and the general public develop more compassion and understanding for ALL people in pain--not just those who have a cancer diagnosis.
What do you think?
Webster LR. What is Noncancer vs Cancer Pain?. Pain-Topics.org News/Research Updates. August 7, 2012.