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Nonwhite cancer patients appear to suffer both worse ongoing and worse short bursts of cancer pain than white patients, according to researchers from the University of Michigan (U-M) Health System.

The study, published in the Journal of Pain and Symptom Management, analyzed data that surveyed 96 people with advanced cancer, including stage 3 or 4 breast, prostate, or lung cancer as well as stage 2 to 4 multiplemyeloma over the course of 6 months.1 The nonwhite patients reported much more severe consistent pain and “breakthrough” pain flares of moderate to severe pain than their white counterparts.

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Illustration 1. Nonwhite patients tend to experience worse cancer pain than white patients.

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Nonwhites, for example, reported scores around 4.75 (on a scale of increasing pain from 1 to 10) for consistent pain at its lowest score. Meanwhile, white patients reported the same score for consistent pain at its worst. Breakthrough pain also was worse for nonwhites; they had an average score of about 4.5 compared with 2.8 for whites. The gap in pain scores tended to decrease during the 6-month study.

Nonwhites also reported more incidences of pain interfering with activity, mood, walking ability, relationships, sleep, and enjoyment of life. Women in the study also reported worse breakthrough pain than men, and their pain flares also were stronger on average than men's.

“Our findings suggest the burden of cancer pain is unequal, with nonwhite patients carrying a larger load,” says lead author Carmen R. Green, MD, director of the pain medicine division and associate professor of anesthesiology and healthmanagement and policy, in a U-M news release.

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  • 1
    Green CR, Montague L, Hart-Johnson TA. Consistent and breakthrough pain in diverse advanced cancer patients: a longitudinal examination. J Pain Symptom Manage. 2009 37:831847.