Practising physicians' experiences of treating patients with cancer pain

To elucidate the reasons for the undertreatment of cancer pain in Finland, a questionnaire survey was made of the experiences of 421 physicians. Their view on the role of the medical authorities, the problems experienced in pain treatment, their opinion about drug abuse and side effects of analgesics and the influence of basic and postgraduate education were requested. Seventy-six percent of the respondents reported difficulties in cancer pain treatment. The main problems seemed to be inefficacy of the therapy, mentioned by half of the respondents, side effects of analgesics (18%), and difficulties in the follow-up (9%) and the psychological support (7%) of the patients. Twenty percent of the physicians reported drug dependence among their cancer patients, but a detailed analysis of the problem revealed that in most cases the physicians used the term for tolerance or withdrawal symptoms. The physicians' own clinical experience, postgraduate education and the example of colleagues were the principal sources of information in cancer pain treatment. It is reasonable to assume that treatment of terminal cancer pain can be more successful within medical practice, provided teaching and training within the field is reinforced.