NEW YORK (Reuters Health) – The results of a new study indicate that 80% of cancer patients undergoing radiation therapy do not use medications to combat pain.

Many of the patients cited fears of addiction as well as the cost as being key factors in not using analgesics. However, the most common reason given was that their healthcare provider did not recommend medication, according to the report in the International Journal of Radiation Oncology, Biology, Physics for September 1.

“To eliminate barriers to optimal pain management for cancer patients, healthcare providers should talk with their patients about pain symptoms and pain medications,” lead author Dr. Charles Simone, from the National Cancer Institute’s Radiation Oncology Branch in Bethesda, Maryland, said in a statement.

Until now, few attempts have been made to quantify analgesic use in oncology patients treated with radiotherapy. The current findings come from an Internet-based questionnaire posted on OncoLink (www.oncolink.org) examining analgesic use and pain control. Data from 106 patients were included in the analysis.

Forty-six percent of patients reported cancer-related pain and 58% of subjects cited treatment-related pain, the authors note. In roughly half of patients the pain was chronic, while in a third, the pain was intermittent.

The only statistically significant predictor of analgesic use was educational level. Specifically, patients with education beyond high school were less likely to use analgesics than those with lower educational levels: 11% vs. 36% (p = 0.002). Lower rates of use were also noted in whites vs. other races (16% vs. 32%) and in women vs. men (17% vs. 29%).

Eighty-seven percent of respondents said that not receiving an analgesic recommendation by their healthcare provider played a role in their not using these agents. Other factors cited included a fear of addition in 79% of respondents and inability to pay in 79%. Patients with pain who chose not to use analgesics often tried alternative therapies.

To improve pain control in radiation oncology patients, Dr. Simone said that his center has instituted an electronic medical record system “that has been designed to require an evaluation and documentation of patient pain levels and pain medication responses by healthcare providers at each patient encounter.”

Int J Radiat Oncol Biol Phys 2008;72:127-133.

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