Cancer pain management by radiotherapists: A survey of radiation therapy oncology group physicians

Purpose: Radiation Therapy Oncology Group (RTOG) physicians were surveyed t o determine their approach to and attitudes toward cancer pain management. Methods and Materials: Physicians completed a questionnaire assessing their estimates of the magnitude of pain as a specific problem for cancer patien ts, their perceptions of the adequacy of pain management, and their report of how they manage pain in their own practice setting. Results: Eighty-three percent believed the majority of cancer patients with pain were undermedicated, Forty percent reported that pain relief in their own practice setting was poor or fair. Assessing a case scenario, 23% woul d wait until the patient's prognosis was 6 months or less before starting m aximal analgesia. Adjuvants and prophylactic side effect management were un derutilized in the treatment plan. Barriers to pain management included poo r pain assessment (77%), patient reluctance to report pain (60%), patient r eluctance to take analgesics (72%), and staff reluctance to prescribe opioi ds (41%), Conclusions: Physicians' perceptions of barriers to cancer pain management remain quite stable over time, and physicians continue to report inadequate pain treatment education. Future educational efforts should target radiati on oncologists as an important resource for the treatment of cancer pain. ( C) 2000 Elsevier Science Inc.