The national cancer institute effort

Abstract

Pain due to cancer continues to be one of the more difficult diagnostic and therapeutic problems in the health care community. While improvements in the treatment of some forms of cancer have resulted in increased survival, pain due to cancer continues to affect the quality of life of many patients. The physical, psychological, emotional and socio-economic morbidity associated with chronic cancer pain is great; new research initiatives and transfer of existing knowledge into effective management practices are needed. To deal with this problem and to promote the use of the technology currently available, the National Cancer Institute is supporting studies in several areas of pain research and control. These studies include research on the pharmacologic control of pain, and clinical research on the assessment of pain management techniques, coping strategies and educational interventions. Through the application of existing pain management techniques, the majority of pain due to cancer can be controlled. In spite of current pain management technology, impediments remain to the adoption by health professionals of the optimal available approaches. Changes in professional and patient attitudes and the adoption of better management practices are keys to achieving an improvement in cancer management. The National Cancer Institute is also supporting studies of the relationship between the pharmacokinetic factors and pharmacologic effects of narcotics commonly used as analgesics. Innovative delivery methods for analgesia and the minimization of side effects in pain treatment are also being addressed. Several scientists are conducting research on psychological interventions to enhance coping mechanisms including stress reduction and other behavioral approaches for cancer patients with pain due either to the tumor or the effects of therapy. Investigators are studying oral pain as it relates to toxicity associated with chemotherapy. They are also researching biological and biosocial factors which affect the incidence and severity of toxic complications, and how these factors influence pain management, hospitalization, and cost. The National Cancer Institute supports educational efforts directed towards improving knowledge of pain assessment methods and the delivery of appropriate pain management. Patient and family member attitudes concerning pain and treatment and the physician-patient interaction in pain management are also areas of interest and support.