The Pain Research Group seeks to improve symptom management through evidence-based clinical trials in symptom control. The common symptoms of cancer and cancer treatment significantly impair the function and quality of life of patients. When pain is present, it significantly compromises patients' mood, level of activity, and ability to relate to others. Similarly, fatigue, nausea and vomiting, shortness of breath, and psychological distress add tremendously to the burden of having a life-threatening disease.

Our clinical trials test the effectiveness of various educational, behavioral, and medical interventions on pain, fatigue, cognitive impairment, and other symptoms. A collaborative multi-site study with the Eastern Cooperative Oncology Group examines the effects of an analgesic protocol on physicians' management of cancer pain. Other multi-site studies measure the effects of culturally-specific pain relief education in minority outpatients, including African Americans, Chinese Americans, and Hispanics. Additional Pain Research Group clinical trials test the use of relaxation, distraction, or imagery in combination with opioids for the treatment of cancer pain. We are also exploring ways that recent technological advances, such as Interactive Voice Response Systems and octaphonic sound, can be employed to improve the comfort and function of patients with cancer.

Pain Relief Education in Minority Outpatients (PREMO)

The majority of ambulatory outpatients with metastatic cancer have pain and one-third have pain so severe that it restricts their ability to function. Outpatients with cancer from underserved populations are at especially high risk for poor pain management C these patients are three times as likely to be prescribed analgesics too weak to control their pain. Our data indicate that over 60% of African-American and over 80% of Hispanic outpatients with cancer-related pain receive less than adequate analgesic prescriptions. As with non-minority patients, these patients often have exaggerated concerns that limit their reporting of pain and their use of analgesics. They also face additional barriers to pain management in terms of limited contact with providers, difficulty paying for medications, and greater health care professional concern about addiction. Educating these patients about pain and its management and training them with the skills they need to obtain pain relief should improve their pain control and increase their ability to function. We are currently testing the efficacy of a educational intervention for pain control in two clinical trials: pain management skills for minority prostate cancer patients and pain management skills for minority breast cancer patients.

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References

Cleeland CS, Gonin R, Baez L, Loehrer P, Pandya KJ. Pain and treatment of pain in minority patients with cancer. The Eastern Cooperative Oncology Group Minority Outpatient Pain Study. Annals of Internal Medicine 1997; 127:813-816.

Cleeland CS, Gonin R, Hatfield AK, Edmonson JH, Blum RH, Stewart JA, Pandya KJ. Pain and its treatment in outpatients with metastatic cancer. New England Journal of Medicine 1994; 330:592-596.