Internet-based survey evaluating use of pain medications and attitudes of radiation oncology patients toward pain intervention.
OBJECTIVE
Pain is a common symptom among cancer patients, yet many patients do not receive adequate pain management. Few data exist quantifying analgesic use by radiation oncology patients. This study evaluated the causes of pain in cancer patients and investigated the reasons patients fail to receive optimal analgesic therapy.


METHODS
An institutional review board-approved, Internet-based questionnaire assessing analgesic use and pain control was posted on the OncoLink (available at www.oncolink.org) Website. Between November 2005 and April 2006, 243 patients responded. They were predominantly women (73%), white (71%), and educated beyond high school (67%) and had breast (38%), lung (6%), or ovarian (6%) cancer. This analysis evaluated the 106 patients (44%) who underwent radiotherapy.


RESULTS
Of the 106 patients, 58% reported pain from their cancer treatment, and 46% reported pain directly from their cancer. The pain was chronic in 51% and intermittent in 33%. Most (80%) did not use medication to manage their pain. Analgesic use was significantly less in patients with greater education levels (11% vs. 36%, p = 0.002), with a trend toward lower use by whites (16% vs. 32%, p = 0.082) and women (17% vs. 29%, p = 0.178). The reasons for not taking analgesics included healthcare provider not recommending medication (87%), fear of addiction or dependence (79%), and inability to pay (79%). Participants experiencing pain, but not taking analgesics, pursued alternative therapies for relief.


CONCLUSIONS
Many radiation oncology patients experience pain from their disease and cancer treatment. Most study participants did not use analgesics because of concerns of addiction, cost, or failure of the radiation oncologist to recommend medication. Healthcare providers should have open discussions with their patients regarding pain symptoms and treatment.
Department of Radiation Oncology, Hospital of the University of Pennsylvania, Philadelphia, PA, USA. simonec@mail.nih.gov
Charles B
CB
Simone
Neha
N
Vapiwala
Margaret K
MK
Hampshire
James M
JM
Metz
D000701:Analgesics, Opioid / Q000627:therapeutic use*; D001290:Attitude; D001943:Breast Neoplasms / Q000150:complications / Q000532:radiotherapy*; D002908:Chronic Disease; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008175:Lung Neoplasms / Q000150:complications / Q000532:radiotherapy*; D008297:Male; D010051:Ovarian Neoplasms / Q000150:complications / Q000532:radiotherapy*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology / Q000523:psychology; D011795:Surveys and Questionnaires
D000701:Analgesics, Opioid