Managing cancer symptoms: NIH panel urges doctors to treat more than the tumors

Physicians are asked to quantify the pain, depression and fatigue of their patients with cancer using measurement scales to prompt responses.

By Susan J. Landers, AMNews staff. Aug. 12, 2002.

Washington -- On a scale of one to 10 -- with one being never and 10 meaning always -- how would most primary care and other office-based physicians rate in regard to whether they ask patients with cancer how much pain they're experiencing?

Probably near the low end, concluded a panel at the National Institutes of Health last month. And even fewer physicians are asking cancer patients about their depression and fatigue, which, along with pain, are common symptoms.

The pain, depression and fatigue that can accompany cancer are often neglected in the drive to attack the disease, said the panel of experts meeting for a "state-of-the-science" conference on cancer symptom management July 15-17.

Cancer has been transformed in recent years from a usually fatal disease to a curable illness for some people and a chronic condition for many others, they said. However, not as much attention has been paid to cancer's other symptoms.

Calling the lack of treatment, "simply unacceptable," panel chair Donald Patrick, PhD, said "there are effective strategies to manage these symptoms and all patients should have optimal symptom control." Dr. Patrick is professor of health sciences and director of the Social and Behavioral Research Program at the University of Washington School of Public Health and Community Medicine in Seattle.

The barriers to care identified by the panel include doctors' lack of knowledge about effective treatment strategies, patient reluctance to report symptoms and inadequate coverage and reimbursement for some treatments. [...]