Taking Action to Control Cancer Pain Rebecca Kirch Associate Director, Policy October 2008

Painkillers often hit the headlines … Rising use of painkillers taking deadly toll Prescription drug deaths overtake those from street drugs Las Vegas Sun (NV)

Stories of suffering pain patients often don’t Many cancer patients forgo painkillers Mon Sep 29, :06pm EDT NEW YORK (Reuters Health) Many Cancer Patients Receive Insufficient Pain Management Therapy ScienceDaily 09/09/2008

Pain Hurts Everyone “The answer to that old question, does cancer hurt? That’s an easy one. Yes.” -- L eroy Sievers, posted October 12, 2007

Cancer Pain: A Persisting Problem Nearly all cancer pain CAN be relieved, but: (1)Pain prevalence in cancer patients is consistently high: 64% advanced disease 59% active treatment, and 33% after treatment concludes (2) One-third rate pain as moderate to severe, but fewer than half receive adequate pain relief (3) Pain burden is even greater in medically underserved populations and treatment disparities exist (4) Uncontrolled pain can devastate quality of life for patients, survivors and their loved ones

National Cancer Information Center Pilot Pain Project (2007) Questions (1)Experiencing pain? (2)Discussed with doctor or nurse? (3)If so, what did they do to help you? Findings: Pain reported in 50% of callers Some did not raise pain with doctor Treatment approaches varied

Pain Project Phase 2: Identify and Quantify the Problem (2008) Just over half the callers were experiencing pain, with nearly 60% rating it moderate or severe An overwhelming majority said they told their healthcare team and felt they were heard But about two-thirds of those callers were not getting adequate relief, rating their pain as moderate or severe

Barriers to Pain Control Fear, misperceptions and confusion about addiction, dependence, and pain medicines Lack of knowledge and reluctance among patients and loved ones Insufficient training for healthcare professionals Concerns that prescribing will trigger investigation, disciplinary action, or criminal prosecution

Pain & Policy Studies Group Report Card ACS Nationwide Pain Control Objective By 2015: 50 states & DC get at least a B 10 of those states get an A This year, 33 states received at least a B and 5 of those received an A

National Pain Care Policy Act (S. 3387/HR 2994) Institute of Medicine Pain Conference and Report NIH Pain Research Coordination Healthcare Professional Education & Training Public Awareness Campaign

Helpful Pain Information at

ACS Commitment “More needs to be done to effectively address the national health crisis of under-treated pain… Patients, health organizations, healthcare professionals, journalists, regulatory officials, licensing boards, and policymakers all have a role to play to promote a balanced approach to pain control policy and practice.” John R. Seffrin, Ph.D., CEO, American Cancer Society