SEATTLE—Unrelieved cancer pain is a serious problem for over a
million Americans with cancer. Many studies report factors that alleviate
pain, but few report factors that aggravate it.

University of Washington researchers Marjorie Wells, PhD, ARNP; Hsiu-Ying
Huang, PhD, RN, AOCN, and Diana J. Wilkie, PhD, RN, FAAN, analyzed the
results of four studies in which a total of 577 cancer patients had been
asked about their pain using the McGill Pain Questionnaire (MPQ).

The two relevant questions on the MPQ are: "What kind of things
relieve your pain?" and "What kind of things increase your
pain?" The University of Washington researchers compiled the answers,
categorized and coded them, and presented results of their secondary
analysis at the Oncology Nursing Society’s 26th Annual Congress in San
Diego.

The researchers discovered that some people simply do not know what makes
their pain feel better or worse. When asked about aggravating factors, 7.3%
said "nothing or don’t know." When asked about alleviating
factors, 3.6% said "nothing or don’t know."

The analysis also drew attention to the fact that the same things can be
either alleviating or aggravating, even in the same person, ie, changing
position can aggravate or alleviate pain; inactivity can relieve it or
increase it; eating can sometimes be helpful, but swallowing acidic food or
spicy food can aggravate it.

In the list of aggravating factors, only three factors—negative mood,
tension, and daytime-time of day—did not also appear on the list of
alleviating factors. Conversely, only three items on the alleviating factors
list— spiritual, herbal medications and treatment, and distraction/pets—did
not appear on the aggravating factors list.

Dr. Wells, a senior postdoctoral fellow with the Cancer Pain and Symptom
Management Nursing Research Group at the University of Washington, said that
further research is needed to study under what conditions the same factor
can either alleviate or aggravate pain.