PONTE VEDRA BEACH, FlaA descriptive study drawing
cancer patients from seven outpatient clinics has found that female patients
with bone metastases were prescribed half the pain medication as male patients
with the same pain intensity scores. The disparity was significant whether the
researchers counted all of the analgesics prescribed to each patient or only
the opioid analgesics.
Christine Miaskowski, RN, PhD, chair, Department of
Physiological Nursing, University of California, San Francisco, presented
preliminary results at the Oncology Nursing Society’s Sixth National
Conference on Cancer Nursing Research. She said the findings suggest that women
with cancer-related pain are at significant risk for undertreatment.
The study showed that the women were prescribed 148.5 mg/d of
opioid analgesics on average, compared with 297.9 mg/d prescribed for the men.
Controlling for weight did not eliminate the disparity, according to Dr.
Miaskowski. "It’s hard to know why at this point, but it certainly is a
red flag, and people need to be aware of it," she told ONI in a
The researchers recorded the medications that had already been
prescribed to 46 men and 88 women at the point when they entered a large
randomized trial of a nursing intervention for pain management in patients with
bone metastases. The intervention had not yet begun when the data were
Most (72%) of the women were breast cancer patients. Nearly
half (43.5%) of the men had prostate cancer. The women were younger than the
men (average age, 56.9 vs. 65.3 years). They also were better educated, with 15
years of schooling vs 13.7 years for the men.
The results showed no gender differences in pain intensity
measures, such as average, least, or worst pain; hours per day or number of
days in pain; or length of pain episodes.
Likewise, men and women gave similar reports of how pain
interfered with normal activities such as walking and sleep. The one exception
was effect on sexual activity, with men rating pain interference at 6.9 on a
0-to-10 scale, and women reporting 5.2.
A tool called the Medication Quantification Scale (MQS) was
used to compare the full range of medications, including nonsteroidal
anti-inflammatory drugs (NSAIDs) and antidepressants, prescribed to help
patients cope with pain.
"This scale allows us to account for all the analgesics
the patients were taking," Dr. Miaskowski said, "because the MQS
units represent an overall estimate of analgesic prescriptions. If you look at
these medications overall, the men got significantly more than the women."
Dr. Miaskowski speculated that prejudice might be a factor, but
she cautioned that relatively little research has been done into gender
differences in feeling, expressing, and treating pain. "We’ve ignored
the differences between the sexes, and now its time to take a better
look," she said.