Breast cancer pain more severe in non-whites

Results of a study show significant racial differences in the risk of pain associated with advanced breast cancer, with non-whites experiencing poorer pain control than women of other races.

Chronic or recurrent pain plagues 30 percent of all cancer patients and 60 to 90 percent of patients with advanced cancer. Age, race, type of cancer, genetics, psychosocial context, and culture can all affect pain. The current study is among the first to look at whether race plays a role in cancer patients' pain experiences.

The study by Dr. Liana D. Castel of the University of North Carolina at Chapel Hill and colleagues shows that non-Caucasian women are at risk for more pain and greater worsening of pain over the course of this disease, compared with Caucasian women.

Their findings stem from a study of 1,124 women with advanced breast cancer that had spread to the bones who received standard treatment. One hundred thirteen women were classified as non-Caucasian, which included 64 "Blacks", 17 "Oriental," and 52 "Other." The women completed a brief pain questionnaire several times during 1-year follow-up.

Non-Caucasian patients were 2.52-times more likely than their Caucasian counterparts to experience severe pain, the investigators report in the journal Cancer. Besides race, other predictors for greater pain were inactive performance status and having had radiation treatment.

As noted, non-Caucasian race was also a risk factor for worsening pain during follow-up, the researchers found.

"The two biggest factors...associated with risks of pain were radiation therapy in the preceding 80 days and non-Caucasian race," Castel told Reuters Health.

Castel and colleagues note that their findings confirm published evidence that non-Caucasians are at highest risk for undertreatment of pain, including inadequate dosing and poor access to medication. Racial/ethnic minority patients have also been shown to be at greater risk for dying from breast cancer.

The researchers think future research "should investigate whether non-white women with metastatic disease are treated less aggressively with analgesics, and if so, the underlying sources of this problem should be identified."

SOURCE: Cancer January 1, 2007.