Breast cancer pain more severe in non-whites
By Anthony J. Brown, MD
NEW YORK (Reuters Health) - Results of a study show significant racial differences in the risk of pain associated with advanced breast cancer, with non-whites experiencing poorer pain control than women of other races.
Chronic or recurrent pain plagues 30 percent of all cancer patients and 60 to 90 percent of patients with advanced cancer. Age, race, type of cancer, genetics, psychosocial context, and culture can all affect pain. The current study is among the first to look at whether race plays a role in cancer patients' pain experiences.
The study by Dr. Liana D. Castel of the University of North Carolina at Chapel Hill and colleagues shows that non-Caucasian women are at risk for more pain and greater worsening of pain over the course of this disease, compared with Caucasian women.
Their findings stem from a study of 1,124 women with advanced breast cancer that had spread to the bones who received standard treatment. One hundred thirteen women were classified as non-Caucasian, which included 64 "Blacks", 17 "Oriental," and 52 "Other." The women completed a brief pain questionnaire several times during 1-year follow-up.
Non-Caucasian patients were 2.52-times more likely than their Caucasian counterparts to experience severe pain, the investigators report in the journal Cancer. Besides race, other predictors for greater pain were inactive performance status and having had radiation treatment.
As noted, non-Caucasian race was also a risk factor for worsening pain during follow-up, the researchers found.
"The two biggest factors...associated with risks of pain were radiation therapy in the preceding 80 days and non-Caucasian race," Castel told Reuters Health.
Castel and colleagues note that their findings confirm published evidence that non-Caucasians are at highest risk for undertreatment of pain, including inadequate dosing and poor access to medication. Racial/ethnic minority patients have also been shown to be at greater risk for dying from breast cancer.
The researchers think future research "should investigate whether non-white women with metastatic disease are treated less aggressively with analgesics, and if so, the underlying sources of this problem should be identified."
SOURCE: Cancer January 1, 2007.
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What breastcancer.org says about this article…
Breast cancer pain more severe in non-whites
As more and more research is done, doctors are finding that women of various races have different breast cancer experiences. For example, research has shown that compared to white women, breast cancer in African American women tends to be:
- diagnosed at a younger age
- more advanced at diagnosis
- more likely to be fatal at an earlier age
The study reviewed here found that non-white women diagnosed with advanced (stage III or higher) breast cancer were more likely than white women to have a higher level of pain, as well as pain that got worse during the course of the disease.
Every woman's breast cancer experience is unique. Many of the breast cancer differences in women of various races are because of genetics. Research also has suggested that some of the differences could be because of differences in medical care. It's possible that genetic differences are why non-white women have more pain and more trouble controlling that pain. Still, this study points out that some non-white women might not be getting enough treatment to control their pain.
Pain can be a major part of dealing with breast cancer and treatment for the disease. Pain is a common side effect of treatment as well as the cancer itself. No matter your race, there is no need for you to suffer. If you're in pain, talk to your doctor about ways to manage the pain. There are a number of options, including medications and complementary medicine techniques such as acupuncture, hypnosis, and music therapy. Together, you can find one that is right for YOU.
Controlling pain shouldn't be an afterthought; it should be one of the main components of your breast cancer care.
To learn more, visit the breastcancer.org Pain section.