Researchers prospectively analyzed data from surveying 96 people with advanced cancer: stage III or IV breast, prostate, colorectal or lung cancer, or stage II to IV multiple myeloma over six months. Non-white participants reported much more severe consistent pain and "breakthrough" pain—flares of moderate to severe pain—than whites. Non-white participants also reported a higher incidence of pain interfering with general activity, mood and walking ability.

"Our findings suggest the burden of cancer pain is unequal with non-white patients carrying a larger load," says lead authorCarmen R. Green, M.D., director of the Pain Medicine Research," U-M Department of Anesthesiology and Health Management and Policy. The study appears in the new issue of" The Journal of" Pain and Symptom Management.

In measures of consistent pain at its least, non-whites reported scores around 4.75 on a scale of zero to 10, with zero representing no pain and 10 representing pain at its most severe. Those numbers are similar to white respondents’ scores of consistent pain at its worst, suggesting a noteworthy gap between the two groups.

Breakthrough pain also was worse for non-whites than whites. For instance, non-whites reported average scores of about 4.5 for breakthrough pain at its least at the three-month time point in the study, compared with an average score of about 2.8 among whites. The gap in pain scores between non-whites and whites tended to decrease over the course of the six-month study.

In measures of pain interfering with activity, mood, walking ability, relationships with others, sleep and enjoyment of life, non-whites reported worse pain. For example, non-whites had an average score of about 6.1 in the mood category at the start of the study, compared with about 3.8 among whites.

These measures indicate a greater impact pain has on the quality-of-life of non-white cancer patients than of white cancer patients, Green notes. Other quality-of-life measures in the study, however, showed little difference between the two groups.

Among women in the study, breakthrough pain was found to be higher on average than for men, and women’s most recent pain flares also were stronger on average than men’s flares.

This study augments Green’s years of research on the topics of pain, disparities in treatment and access to pain care revealing an unequal burden of pain for non-whites. For more information, visitwww.med.umich.edu/anesresearch/Green.htm.

Authors: In addition to Green," Tamera Hart-Johnson, M.S., and Laura Montague, B.S., were authors of the paper.

Funding: Blue Cross Blue Shield of Michigan Foundation.

Reference:" The Journal of" Pain and Symptom Management, May 2009, Issue 5, "Consistent and Breakthrough Pain in Diverse Advanced Cancer Patients:" A Longitudinal Examination"

Written by Katie Vloet