STUDY: TOO MUCH CANCER PAIN

WASHINGTON - Cancer patients often suffer needlessly because the nation's
medical system does a poor job of treating pain that is a common part of
the disease, according to experts who produced a study for the National
Institutes of Health.

"Cancer-related pain, depression and fatigue are undertreated and this
situation is simply unacceptable," said Dr. Donald Patrick, a medical
professor at the University of Washington, Seattle, and committee chairman.

"We have to move to the point that patient comfort and care are a part of
the cancer treatment agenda," said Dr. Andrew Turrisi III, a radiation
oncologist at the Medical University of South Carolina, Charleston. "Some
patients are more fearful of pain than they are of death itself."

"Optimal pain relief for cancer patients needs to be a minimally accepted
standard," the committee statement said. "Inadequately treated pain can be
considered one indicator of poor quality of care."

The report was written after the 13-member panel analyzed studies over a
two-day period at a conference organized by NIH.

At a news conference where the report was released, Patrick said the group
found that many doctors lack the knowledge of how to control relentless
pain and that medical schools fail to provide adequate training in pain
management.

"The educational process needs to be rethought," said Patrick. "Students,
trainees and post graduates all need additional training in management,
assessment and treatment of pain."

There are also official barriers to bringing relief to suffering patients,
the panel said.

Dr. Paul Frame, a professor at the University of Rochester School of
Medicine in New York and a member of the committee, said some government
regulations require a three-copy report each time a doctor prescribes some
opiates commonly used for cancer pain relief.

"Sometimes practitioners don't want to go to the hassle of prescribing a
triplicate drug," he said. "They may use something less effective instead."

Even the day of the week can block pain relief for cancer patients, said
Douglas Ried, a professor at the college of pharmacy, University of
Florida, Gainesville.

Ried said regulations require that a patient get a new prescription for
some opiates used for pain relieve. If, for instance, a patient runs out of
morphine on a weekend, "it is very difficult for him to get another
prescription" because his doctor is not available and a pharmacist is not
allowed to sell more of the drug without a doctor's approval.

"Sometimes pharmacists will fill the prescription and then call the doctor
on Monday, but they are putting their license at risk," Ried said. "Most
pharmacists, though, follow the regulations to the letter," which leaves
the patient in pain.

Even the size of the pain problem is uncertain, the committee said. The
report estimated there are nearly 9 million people in the United States
with a history of cancer, with about 1.3 million additional patients
diagnosed each year. About 60 percent will live at least five years.

The committee said some researchers studying pain management said only
about 14 percent of cancer patients have persistent pain. Other studies
found that relentless pain affected virtually every cancer patient. The
most common estimates found that pain was poorly controlled in 26 percent
to 41 percent of all cancer patients.