Cancer patients face much pain and fatigue. But many of them are not getting the pain relief they deserve.
Reuters reports on cancer treatment.
Numerous patients are not getting the pain relief they need because they are worried about getting addicted to the strong medications physicians prescribe to them today.
Researchers say that due to fears of opioid abuse and addiction patients with advanced cancer are trying to keep themselves from getting enough pain medication. Pain under treatment is predicted to affect around fifty percent of cancer patients. The researchers’ report was recently published in the Journal of Clinical Oncology.
How do patients get addicted to these medications?
Opioids are a type of narcotic. They work in the spinal cord and brain to decrease the intensity of pain signals reaching the brain. The opioid family includes medications such as: hydrocodone (Vicodin), hydromorphone (Dilaudid) and oxycodone (Oxycontin, Percocet) these are a group of painkillers that physicians commonly prescribe. The International Narcotics Board recently said hydrocodone is actually the most prescribed medicine in the United States now.
How common is addiction of opioids?
Opioid addiction and abuse are a large problem that gets lots of attention in the news media – and that may keep cancer patients and physicians from utilizing them properly.
“Underuse worries Judith Paice, a pain specialist at Northwestern University Feinberg School of Medicine in Chicago. She said, ‘Part of the problem is that it’s sometimes hard for patients to convey to doctors how severe the pain is. Most pain is controllable, she maintains; patients must describe symptoms, and physicians must seriously consider them. All pain is real to the person experiencing it. But unlike infections we measure with blood samples, it doesn’t have an objective marker. The zero to ten scale was a good beginning when introduced to quantify pain. Unfortunately, it’s now a check in the box. It’s another thing physicians ask, and patients feel frustrated because they don’t feel doctors take it to the next step and work on their pain’.”
Experts are saying that physicians need to have a better screening system for figuring out whom genuinely needs the medication and should be prescribed it. They say today doctors use an extremely general system where they simply ask the patient how bad their pain is on a scale of one to ten. But experts say this is not an accurate method anymore.
So what should doctors do?
Many experts are saying physicians should have patients elaborate on exactly what kind of pain they are having. They should ask for adjectives such as tingling, burning etc.
Also there are other options other than narcotics for treating pain.
“Narcotics are not the only option for treating pain. Mr. Fehling, a University of Colorado Hospital addiction psychiatrist, says anxiety often makes pain worse. In some cases, he told Reuters Health, pain should be treated with interdisciplinary counseling from social workers, clergy or psychologists. Research suggests complementary treatments such as massage and acupuncture may also be beneficial,” according to Reuters.
Fehling actually also told Reuters, “Patients might say, I have pain and would like it taken away. But their experience might be they felt pain on a three out of ten level, and they wanted zero. That’s not always realistic.”
Some people are at a higher risk of getting pain they are unable to control. Being that everyone’s pain level is different, the way narcotics are prescribed should depend on a person’s individual body.
“Some populations are at particularly high risk for inadequate pain control. For example, research has shown that patients in minority care settings are three times more likely to receive under treatment than those in non-minority settings. Sixty percent of African-American and 74 percent of Hispanic outpatients with cancer-related pain reported inadequate prescriptions. ‘This is a most vulnerable population,’ said Egidio Del Fabbro, a Virginia Commonwealth University palliative specialist, ‘to undertreat them is something we should avoid at all costs.’ Research cites unrelieved pain as the greatest fear among the terminally ill.”
Despite the fact that stigmas are keeping doctors from prescribing adequate pain medication in certain patient populations, similar misconceptions may keep patients from seeking medication thus causing them to endure great pain.