What are some reasons for not receiving adequate treatment for cancer pain?

Unfortunately cancer pain is often undertreated. Many factors can contribute to that, some of which include:

• Reluctance of doctors to ask about pain or offer treatments. Health care professionals should ask people with cancer about pain at every visit. Some doctors don't know enough about pain treatment. In that case, request a referral to a palliative care or pain specialist.

  Given current concerns about opioid use and abuse, many doctors might be reluctant to prescribe these medications. Maintaining a close working relationship with your cancer specialists is essential to proper use of these medications.

• Reluctance of people to mention their pain. Some people don't want to "bother" their doctors, or they fear that the pain means the cancer is worsening. Others are worried their doctors will think of them as complainers or that they can't afford pain medications.

• Fear of addiction to opioids. The risk of addiction for people with advanced cancer who take pain medications as directed for cancer pain is low.

  You might develop a tolerance for your pain medication, which means you might need a higher dose to control your pain. Tolerance isn't addiction. If your medication isn't working as well as it once did, talk to your doctor about a higher dose or a different drug. Don't increase the dose on your own.

• Fear of side effects. Some people fear being sleepy, being unable to communicate, acting strangely or being seen as dependent on medications. You might have these side effects when you start taking strong pain medications, but they often resolve once your doctors find the correct level of pain medications for you and once you achieve a steady level of pain medicine in your body.