Breakthrough Cancer Pain Is Top Challenge for Cancer Patients, Even When Using Pain Treatments, New Survey Reveals

April 9, 2010

A survey recently released by the American Pain Foundation (APF) reveals that breakthrough cancer pain is one of the most challenging aspects of having cancer, according to 75% of US adults who have ever been diagnosed with cancer and experience this type of pain. The survey also found that breakthrough cancer pain negatively impacts quality of life, contributes to additional financial hardships, and can interfere with one’s ability to cope with other aspects of cancer treatment.

Restoring Quality of Life

“We’re not talking about minor aches and pains,” said Will Rowe, APF’s chief executive officer. “These severe flares of pain often strike without warning, leaving many people fearful of the next crippling episode and unduly burdening patients and their families. Effective pain management is critical to restoring the quality of life these individuals so rightfully deserve.”

More than half of those surveyed (53%) rated their pain an 8, 9, or 10 out of 10, with 10 being the worst pain imaginable. While 44% said their pain is not adequately controlled, a vast majority (91%) believe their quality of life would “greatly improve” if they could get their breakthrough cancer pain under control.

The survey, commissioned by APF and conducted online by Harris Interactive, is the first to explore the impact breakthrough cancer pain has on a patient’s quality of life, medical treatment, and finances among adults who have been diagnosed with cancer, are currently living with cancer-related pain, are taking medication to manage the pain, and experience sudden, temporary pain flares.

According to the survey:

• 73% said breakthrough cancer pain wakes them from a deep sleep at least once a month

• 76% reported that breakthrough pain affects their ability to perform everyday household chores

• 83% indicated that breakthrough cancer pain affects their desire to participate in certain activities.

Breakthrough Cancer Pain Needs More Attention

The vast majority (95%) of those who currently see a health-care provider for their cancer or cancer pain have discussed breakthrough cancer pain with their health-care provider at some point. Incidentally, more than half (52%) said their health-care provider has described breakthrough cancer pain as a normal side effect of cancer or its treatment.

“The phenomenon of breakthrough cancer pain presents a challenge for patients and their health-care providers because it occurs even when a patient is taking the right dose of medication on a regular basis,” said Russell K. Portenoy, MD, Chairman of the Department of Pain Medicine and Palliative Care at Beth Israel Medical Center and member of the board of directors for APF. “Providers and patients should not accept breakthrough cancer pain as a normal side effect of cancer. More studies are needed to determine the most effective treatments to alleviate this pain.”

by Sarah Dees | April 16, 2010 11:34 AM EDT

Doctors need to understand the impact of breakthrough pain and do more to help cancer patients with this aspect of treatment. My meds were prescribed by my neurologist during cancer treatment, not my oncologists. The oncologists were very stingy with prescribing pain meds, while my neurologist did not hesitate to give me what I needed to be comfortable. While I was in chemo treatments and radiation, I would be using the Actiq lozenges or "lollipops"to control breakthrough pain. Many other cancer patients asked me, "What is that?" I told them what it was, and what it was for. None of them had been offered the medication by their doctors. I told them to ask for the medicine, that they were entitled to have enough pain medication to cover their breakthrough pain. They would go back to their doctors and ask for it, then begin to use it. Why wasn't this offered to them in the first place? Why do patients have to learn about pain meds for breakthrough pain from another patient, instead of being made aware of all options available to them from the start by their own doctors?

As a side note, I want to mention that doctors worry too much about the "addictive effects" of these medicines. When I didn't need them any more, I just stopped using them, weaning off gradually. Cancer patients aren't drug seekers or junkies. They shouldn't be made to suffer more than they already do. Patients need the medication to get through the black days of this treatment, and when it's over, then address weaning off the meds at the appropriate times. Living in pain is far worse than worrying about any future possible addiction problems that haven't even come up yet.

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Breakthrough Cancer Pain Is Top Challenge for Cancer Patients, Even When Using Pain Treatments, New Survey Reveals

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