Among women with breast cancer that has spread to the bone, non-White women are more likely than White women to report severe pain. These results were published in the journal Cancer.
The spread of cancer from its site of origin to another location in the body is called metastasis. Bone is one of the most common locations in the body to which cancer metastasizes. The major cancer types that tend to metastasize to bone include multiple myeloma, breast, prostate, lung, kidney, and thyroid cancers.
A common complication, and often the initial symptom of bone metastases, is bone pain. The thick membrane that covers each bone, called the periosteum, has many nerves, making it a highly sensitive tissue. Damage or pressure to this tissue caused by bone metastases may result in a great deal of pain. Bone pain can be debilitating to the point that it compromises a patient's ability to manage normal day-to-day activities.
Strategies used to manage pain from bone metastases include pain medications, bisphosphonate drugs (drugs that reduce bone loss), and radiation therapy.
To identify factors linked with poorly controlled pain, researchers evaluated information from 1,124 breast cancer patients with bone metastases. All of the women received treatment with one of two different bisphosphonate drugs as part of a clinical trial.
Pain was assessed several times over the course of a year. Pain severity was ranked on scale of 1 to 10, with 10 being the most severe. A pain rating of 1-4 was considered mild, a pain rating of 5-6 was considered moderate, and a pain rating of 7 or higher was considered severe.
Non-White women were significantly more likely than White women to report severe pain. The estimated probability of remaining free from severe pain for the entire study period was 84% among White women and 64% among non-White women.
The study suggests that pain from bone metastases is less well managed among non-White women than among White women. The researchers note that “further investigation should seek to uncover and resolve the reasons for this obvious disparity.”
Reference: Castel LD, Saville BR, DePuy V, Godley PA, Hartmann KE, Abernethy AP. Racial differences in pain during 1 year among women with metastatic breast cancer. Cancer [early online publication]. November 26, 2007.