Science / Medicine : Treatment of Cancer Pain Found to Be Low Priority

Most doctors don’t give enough painkillers to ease the suffering of cancer victims, and nearly two-thirds admit they do a poor job of even learning if their patients hurt, according to a study released last week.

The major reason doctors don’t treat pain aggressively enough is their fear that they will not be able to deal with side effects of the medicines, the study found.

A variety of other factors also play a role, including poor training in pain control and failure to pay attention to patients’ misery.

“Pain has been a low priority. That’s one of the problems,” said Dr. Jamie H. Von Roenn of Northwestern University, who directed the study.

The study was based on a 1989 survey of 1,800 cancer specialists who belong to the Eastern Cooperative Oncology Group, a major cancer study organization. Mailed questionnaires were returned by 1,177 physicians who had treated more than 70,000 cancer patients during the previous six months.

Von Roenn estimated that if used competently, pain medicines can relieve the agony of 80% to 90% of cancer patients.

Among the findings of her report, presented at the annual meeting of the American Society of Clinical Oncology:

--About 60% of doctors acknowledged that poor pain assessment is a major barrier to controlling pain. Von Roenn said doctors could make questions about pain a regular part of their daily rounds but rarely do so.

--Eighty-five percent of doctors surveyed said they believe that the majority of cancer patients in the United States are under-medicated for pain.