[...]... wait for a doctor to ask about the pain Sometimes the doctor may ask, "How are you?" to open a conversation, and the customary polite response of "Fine" may be recorded in the chart as "No pain today." Patients are often reluctant to complain They may feel that time with the physician is limited and their highest priority is to talk about curative treatment They don't want to distract the doctor from this... new to the needs of cancer patients be sure to read Chapter 1 to understand the importance of treating pain and why many doctors and other health care providers neglect to treat it appropriately Chapter 2 is background information about cancer and pain, including types and causes of pain Chapter 3 is critical to un- Preface xi derstanding how to describe different kinds of pain, learning how to make the. .. comfortable in treating their pain by keeping diaries and pain scores Undermedication Is the Norm Since many doctors still undermedicate cancer pain, they compound the error by teaching young doctors to do the same And other doctors feel pressured to adhere to the norm of low doses set by their colleagues Even when an adequate range of doses is prescribed, some studies of postoperative pain show that most... advantage of available resources to fight cancer pain The bottom line: you never need to give up or assume that little can be done to ease the pain and suffering of cancer How Pain Is Harmful—Even Hazardous to Health There is no benefit from enduring cancer pain Pain relief is of the utmost importance, not only for humanitarian reasons but also for medical reasons Pain is harmful and debilitating It interferes... important, it is unrelated to and should have nothing to do with the aggressive treatment of cancer pain (and other chronic pain) with opioids Ten years ago, the state of Wisconsin took the lead with its Wisconsin Cancer Pain Initiative; today every state participates in the American Alliance of Cancer Pain Initiatives, a national network of efforts to raise awareness of the proper use of pain control treatment... doctor from this mission or bother or annoy him with their complaints Some deny the pain in their effort to deny the disease and its possible progress If pain has intensified, patients may not want to admit it; instead, they want to tell the doctor they feel better Or perhaps they don't want to complain because they believe that their "good" behavior will be rewarded and that "bad" behavior will be... doctors and even families, regrettably may feel obligated to "build the character" of the patient by withholding adequate pain relief The other side of the coin is patients who don't seek relief for their pain because they "don't want to be a bother" or they fear they will be perceived as being weak-willed or of weak character When it comes to a fight for one's life, it is not always virtuous to be the. .. disbelieved and untreated, leaving them feeling ridiculed, humiliated, depressed, and even suicidal Often amplified by the absence of the drama associated with cancer, the barriers to good pain management (Chapters 1 and 2) are largely the same for chronic pain Below are some of the barriers that both patients with chronic pain and cancer pain experience in trying to obtain satisfactory pain treatment... to make the most of a pain assessment, and understanding the strategies doctors use in treating cancer pain Chapter 4 covers how to identify doctors who use modern approaches to treating pain and how to be assertive in ensuring that pain and suffering are being appropriately treated Chapters 5, 6, and 7 include detailed information about medications typically used to treat pain and should be used as... now have the means to relieve most pain in almost all patients Now we just need the appropriate use of the arsenal of pain treatment options available to us so that no one suffers needlessly Patients with cancer and their families and friends need to know xii Preface that much of the pain and suffering of living with cancer can be successfully treated Finally, there is the last frontier: the countless . and tomorrow's cancer and pain patients, who deserve the best. And to my mother and father, who always did their level best: her passing humbled me and opened my heart to. Cataloging-in-Publication Data The complete guide to relieving cancer pain and suffering / Richard B. Patt, Susan S. Lang.—Rev. and expanded ed. p. cm. Previously published in 1994 under the title: . a pain assessment, and understanding the strategies doctors use in treating cancer pain. Chapter 4 covers how to identify doctors who use modern approaches to treating pain and