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Cancer Patients Get Simple Words to Say How it Hurts
By Mary Brophy Marcus
Edith O’Neil-Page was once a cancer nurse, but even she had a hard time articulating her need for pain relief as she battled breast cancer three years ago. “Luckily, my husband saw when I needed something and either asked or encouraged me to ask,” says O’Neil-Page, 57, a director at Centinella Hospital and Medical Center in Inglewood, Calif. Now, a new tool for cancer patients and their families may help more of them speak up.
A panel of cancer pain experts put together by the National Comprehensive Cancer Network and the American Cancer Society has developed a set of guidelines to help patients assess and talk about pain, which gets inadequate treatment in about 30 percent of cancer patients, according to recent studies. Doctors have been faulted for their reluctance to prescribe potentially addictive drugs. But patients also contribute to undertreatment of pain. “Many people want to be a ‘good’ patient and appear strong,” says Richard Payne, a pain expert at Memorial Sloan-Kettering Cancer Center in New York, who helped create the guidelines. For others, like O’Neil-Page, depression and fatigue get in the way.
Plain speaking. Published this spring as a 38-page booklet, Cancer Pain Treatment Guidelines for Patients encourages patients to talk about their pain and gives them plain language to describe it. Specific words like “throbbing” and “burning” can help a doctor identify whether pain is emanating from muscle, bone, or nerves (box). The guide also has patients rate their pain on a numerical scale and prompts them with questions such as “How long has it hurt? Is there anything that makes it worse—like eating or sleeping? Did you have pain before your treatment or only after?” And it outlines pain control options.
Patients can view the booklet or order a free copy online at www.cancer.org or www.nccn.org. The authors say that new hospital accreditation standards, which call for pain assessment and management to be a standard part of care, may also encourage hospitals to put copies in patients’ hands.
Reprinted with permission from U.S. News & World Reports (6/18/01).