Cancer pain management by radiotherapists: a survey of radiation therapy oncology group physicians.
OBJECTIVE
Radiation Therapy Oncology Group (RTOG) physicians were surveyed to determine their approach to and attitudes toward cancer pain management.


METHODS
Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patients, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting.


RESULTS
Eighty-three percent believed the majority of cancer patients with pain were undermedicated. Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% would wait until the patient's prognosis was 6 months or less before starting maximal analgesia. Adjuvants and prophylactic side effect management were underutilized in the treatment plan. Barriers to pain management included poor pain assessment (77%), patient reluctance to report pain (60%), patient reluctance to take analgesics (72%), and staff reluctance to prescribe opioids (41%).


CONCLUSIONS
Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiation oncologists as an important resource for the treatment of cancer pain.
Cleeland
C S
CS
Pain Research Group, The University of Texas M.D. Anderson Cancer Center, Houston, TX, USA. ccleeland@mdanderson.org
Janjan
N A
NA
Scott
C B
CB
Seiferheld
W F
WF
Curran
W J
WJ
D000700:Analgesics / Q000008:administration & dosage / Q000627:therapeutic use; D000704:Analysis of Variance; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage / Q000627:therapeutic use; D019538:Health Care Surveys; D006801:Humans; D009294:Narcotics / Q000008:administration & dosage / Q000627:therapeutic use; D009369:Neoplasms / Q000150:complications* / Q000532:radiotherapy; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000532:radiotherapy; D010818:Practice Patterns, Physicians'; D018787:Radiation Oncology / Q000706:statistics & numerical data*; D012044:Regression Analysis; D011795:Surveys and Questionnaires
D000700:Analgesics; D000893:Anti-Inflammatory Agents; D009294:Narcotics