Cancer pain and common pain: a comparison of patient-reported intensities.

PURPOSE/
OBJECTIVES: To compare patient reports of present and worst cancer-related pain intensity to the recalled intensity of several commonly experienced types of pain.
DESIGN: A secondary analysis on baseline data from patients with cancer pain.
SETTING: Tertiary-care facilities and patients' homes. Patients were enrolled between 1988 and 1995. SAMPLE: Patients who were diagnosed with either primary lung cancer or cancer metastatic to bone, able to read and write English, over 18 years of age, and able to provide written informed consent. The sample of 125 patients was 62% male with a mean age of 60 years (SD = 11).
METHODS: Patients completed the McGill Pain Questionnaire as a baseline measure in a pain research study. Investigators conducted comparisons among pain intensity scores reported for present pain intensity and worst cancer pain with the worst toothache, headache, and stomachache ever experienced using the Stuart test of marginal homogeneity. MAIN RESEARCH VARIABLES: Present cancer pain intensity and worst toothache, headache, and stomachache pain intensity.
FINDINGS: Only 14% of the subjects reported that their present pain intensity was distressing, horrible, or excruciating, but 83% of them reported that their worst cancer pain was at these levels. The subjects reported that they experienced (a) significantly more intense pain with their worst toothache than either their present pain intensity (p < 0.001) or their worst cancer pain (p < 0.001), (b) significantly more intense pain with their worst headache than their present pain intensity (p < 0.001), and (c) significantly more intense pain with their worst stomachache than their present pain intensity (p < 0.001). In contrast, subjects reported that their worst cancer pain was significantly more intense than their worst headache (p = 0.047) or stomachache (p = 0.001).
CONCLUSIONS: The findings suggest that present cancer pain is not only experienced at lower intensity levels than common pains, but at lower levels than expected by patients, their families, and the public. Consistent with common beliefs though, the worst cancer pain is severe and not adequately controlled for 9 out of 10 patients. IMPLICATIONS FOR NURSING PRACTICE: Healthcare professionals could use study findings to inspire hope in patients with lung cancer or bone metastasis and their families that present pain in cancer can be controlled successfully. Clinicians should devote greater efforts to relieve the worst cancer pain to levels achieved for the present pain experienced by people with cancer.