Pain Takes Significant Toll on Cancer Survival

Pain Takes Significant Toll on Ovarian Cancer Survival, Study Shows – by Alberto Molano, PhD – Sep 2019

This study shows that constant pain is so damaging to health that it can shorten the life span. Any other symptom that led to such dismal outcomes would be treated aggressively and immediately as an emergency.

However, since pain is invisible and can only be determined by the patient themselves, it is doubted and left poorly treated, if at all. When pain medication is withheld from a patient, their constant pain can lead to an early death. This should be clear malpractice, but in today’s opioidphobic society doctors are pressured to do exactly that: leave pain poorly treated even though it’s detrimental to a patient’s health and welfare.

For the first time, scientists have found evidence that pain is an independent marker for overall survival in recurrent ovarian cancer, with women with pain living for significantly less time after their diagnosis than those without pain.
The survival toll is particularly high for patients with pain despite receiving pain medication, who have seven months less to live than women without pain.

I wonder what they mean when they say “despite receiving pain medication”. This could easily be because doctors are simply not prescribing sufficient doses of opioids – or even using only non-opioid pain treatments which are much less effective.

Seven months is a lot of life to lose, yet no one is pressuring doctors to improve pain treatment.

The findings underscore the importance of effective pain management in ovarian cancer patients, the researchers said.

Alnd not just in ovarian cancer, but all cancers, and not just cancer, but all chronically painful disorders.

Pain has not only an immense impact on quality of life and functioning but also on overall survival in ovarian cancer,” the investigators said.

“Inadequate pain management was associated with decreased survival.”

This is a strong statement, leaving no doubt. Reading this article would make a person wonder why they aren’t just giving patients more pain medication so they can survive longer. It’s clear that PROPaganda and media myths are ruling medical practice these days.

The study, “The Prognostic and Predictive Role of Pain Before Systemic Chemotherapy in Recurrent Ovarian Cancer” was published in the journal Supportive Care in Cancer.

I’ve included that article below.

Pain is a very common symptom among cancer patients and survivors, and it significantly affects quality of life and mental health.

This article and the study are specifically about ovarian cancer, but they extrapolate to all cancer patients. Do they really believe that for chronic pain patients without cancer, “quality of life and mental health” are not improved by sufficient pain management?

However, despite guidelines by multiple organizations for pain management, optimal pain medication remains a challenge.

It’s the guidelines that are destroying pain treatment by focusing mainly on opioid milligrams instead of the goal of pain relief.

On top of that, physicians tend to underestimate pain in cancer patients, particularly in women, the study found. The researchers sought to determine if pain influences the survival of women with ovarian cancer.

Doctors “underestimate pain” in all pain patients, not just those with cancer. When they have to rely on patient reports of this symptom, they remain skeptical and afraid to prescribe opioids.

I wasn’t able to see more of the article because it’s behind a paywall, but below is the scientific study it was based upon:

The prognostic and predictive role of pain before systemic chemotherapy in recurrent ovarian cancer: an individual participant data meta-analysis of the North-Eastern German Society of Gynecological Oncology (NOGGO) of 1226 patients | SpringerLink – August 2019

Aim of this study was to analyze the impact of pain on quality of life and survival in recurrent OC patients.


  • Data on pain was available for 952 patients out of 1226.
  • Moderate to severe pain, which was defined as pain ≥ 50 in the QLQ-C30 symptom scale, was experienced by more than one-third of patients (36.6%).
  • A total of 31% were taking non-opioid pain medication and 16% opioids.
  • Median age at randomization was 61 years (range 25–84).
  • Most patients (84.7%) were diagnosed in FIGO III/IV [International Federation of Gynecology and Obstetrics cancer grading]

Pain was independent from age, FIGO stage, grading, amount of recurrences, and chemotherapy-free interval.

This tells us that, as usual, pain defies clear definition or indication. Pain is 100% dependent on the individual who has it because no diagnosis or intervention or health history can explain it.

ECOG was significantly worse in patients with pain (p < 0.001). Fatigue, nausea/vomiting, sleeping disorders, and abdominal symptoms such as loss of appetite, diarrhea, and constipation were more frequently found in patients with pain (all p < 0.001). Quality of life was significantly diminished (p < 0.001).

Pain was also an independent marker for overall survival (OS).

Median OS was 18.2 months in patients with pain compared with 22.0 months in patients without pain (p = 0.013, HR 1.25, 95% confidence interval 1.05–1.48).

OS was shorter in patients with pain and without pain medication compared with those on sufficient pain medication,

This study unequivocally shows that persistent insuficiently treated pain leads to shorter survival, while properly treated pain has no such negative effect.

…whereas OS was mostly decreased in patients having pain despite pain medication (18.5, 19.6, and 15.0 months respectively; p = 0.026).

When withholding opioid medication is contributing to an earlier death, It seems criminal not to give those poor women enough to control their pain.

Best supportive care including sufficient pain medication should be delivered as early as possible because effective pain management is crucial for both quality of life and overall survival in patients with recurrent ovarian cancer.

I suppose all the anti-opioid zealots would believe the same isn’t true of non-cancer pain, yet there is no categorical difference between cancer and non-cancer pain: NO DIFFERENCE between cancer and non-cancer pain.

4 thoughts on “Pain Takes Significant Toll on Cancer Survival

  1. Flutterby

    Luckily, I see the palliative care doctor today. Not only breast cancer for me, but lymph nodes, sternum, and possibly liver. Treatable, not curable, and will definitely shorten life. My hope is to get enough pain meds so I’m comfortable and able to do a few small things like crochet or needlework. I’m not going to hold my breath though.


      1. Flutterby

        Eh, not so much. He ended up talking to me more about the fibromyalgia than the pain from the cancer. Dude, I’m not in the cancer care center for my fibro. He let me fill the script for tramadol, even though he doesn’t like to use the med with patients – he likes to keep the relationship with the primary care doctor… Mmm, the one I want to slap with a malpractice suit. And if I get a new primary care, they’re most likely not going want to prescribe opioids… What then?

        Liked by 1 person

        1. Zyp Czyk Post author

          I wonder why a cancer doctor would be so focused on fibromyalgia? With a visible, verifiable known to be painful cancer growth, he focuses on a syndrome with unverifiable pain. Tramadol usually isn’t strong enough for cancer pain, so he must be prescribing it for fibromyalgia pain.

          I guess it’s a good sign that he’s willing to treat pain that is not visible and relies on a patient’s reporting. But that could be because he generally expects the primary doctor to treat it. Hard to say how this will go, but for a first visit it seems promising.



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