Misconceptions on use of opioids leave patients in pain
As the incidence of cancer has risen in China over the past few decades, wide misconceptions about alleviating the pain it can bring have compromised the prospects of recovery and the quality of life of Chinese with the disease, medical experts say.
They made the comments in Beijing this month as a charity program for those suffering with cancer pain was established. It aims to raise public awareness on cancer pain as a specific illness that needs to be treated, and to provide quality care and support to patients and their families.
The program was initiated by organizations that do research on oncology and pain treatment, including the Chinese Association of Oncology, and the Chinese Association for the Study of Pain.
Fan Bifa, a committee member of the fifth committee of the Pain Medicine Branch of the Chinese Medical Association, and director of the pain management department of the China-Japan Friendship Hospital in Beijing, says: “More than 10 years ago international health experts accepted that cancer pain is a chronic disease that needs standardized treatment and management, but in China, patients do not welcome such treatment because they often fear they will become addicted to anti-pain drugs.
“Of course that belief is misconceived, but it is widespread.”
For Chinese, opioids have undertones of the country’s so-called century of humiliation starting with the First Opium War (1840-42) and lasting until 1949 when the People’s Republic of China was founded.
However, fear of addiction to opioids is groundless because they do not give those who are suffering pain the euphoria that healthy people draw from them, Fan said. Nevertheless, there may be some side effects that require the attention of professionals, he says.
Chinese health authorities have long worked to educate the public, to train medical professionals and to enforce policies relating to the dispensing of pain treatment. Theoretically, access to pain relief drugs, mostly opioids, is relatively easy, but the popular misconceptions prevent people seeking or being given effective pain treatment and management, Fan says.
The prevalence of late-stage cancer in China makes matters worse, he says.
“Cancer causes pain by growing into or destroying tissue near the cancer, and by putting pressure on nerves, bones or organs,” says Li Pingping, a cancer and pain specialist with Peking University Cancer Hospital, who is also vice director of rehabilitation and palliative care professional committee, part of Chinese Anti-Cancer Association, part of the Chinese Anti-Cancer Association.
“Not all cancer patients suffer from cancer pain, but in China the situation is severe because most cancer patients are not diagnosed until they have reached the middle to late stages, which often comes with severe pain.”
During the media conference, a report on cancer pain treatment in China was distributed highlighting the issue, which was based on a three-month survey conducted by the cancer rehabilitation and palliative care professional committee, part of the Chinese Anti-Cancer Association, in more than 100 hospitals nationwide this year.
About 12,000 cases of cancer are reported in China every day, and health authorities say about 61.6 percent of those with the disease suffer from associated pain, half of them having moderate to severe pain, and 30 percent unbearable pain.
Yet about 70 percent of cancer pain patients receive no standardized anti-pain treatment, and that results in both psychological and physical suffering among patients and families, the report says.
Only 28 percent patients seek medical advice within 10 days after the onset of pain, and one third seek medical help one month to half a year later, the report said. For those who seek medical help, only 35 percent will get treatment within 10 days, and most will not have treatment until a month later.
About 76 percent of Chinese hospitals now use opioids, the internationally recognized cancer pain medication, to treat cancer pain. Yet half of those with moderate cancer pain and 25 percent with severe pain receive only non-strong opioid treatment that is designed for those with mild to moderate pain.
More than 90 percent of hospitals and medical institutions at county and village have no access to opioids, because of policies on drug sourcing, prescription and insurance, the reports says.