What is cancer pain? Investigating attitudes of patients, carers, and health professionals: A cross-sectional survey

Background: Cancer pain is a prevalent and debilitating symptom that impacts quality of life. Pain management remains challenging; however, due to various barriers, including stigma associated with opioid use, ambiguous roles of clinicians, and diverse attitudes toward pain management among healthcare professionals, patients, and carers. Objective: To explore the attitudes surrounding cancer pain among patients, carers, and health professionals at a tertiary cancer hospital. MethodsA cross-sectional online survey was conducted at the Peter MacCallum Cancer Centre. The survey included demographic measures and statements assessing attitudes toward cancer pain management. Data was analyzed using descriptive statistics in IBM SPSS 29. Ethics approval was granted by the Peter MacCallum HREC. Results: 308 participants (153 patients and carers, 155 health professionals) completed the survey. The results revealed significant variability in attitudes surrounding cancer pain and its management. Discrepancies in understanding between health professionals and patients/carers were observed. Differing views on the goals of pain management were revealed, with 51.6% of patients/carers expecting pain elimination compared to 20.6% of health professionals. The roles of clinicians in pain management were also perceived differently, highlighting a lack of clarity in responsibilities. Both groups emphasized the need for increased education on cancer pain and its management. Conclusions: The study revealed substantial variability in attitudes toward cancer pain management among patients, carers, and health professionals. Discrepancies emerged in understanding, with many patients and carers uncertain about the nature of cancer pain, contrasting with health professionals' recognition of its complexity. The terminology distinguishing "cancer pain" from "non-cancer pain" may contribute to this confusion, suggesting a need to reconsider these semantics. Divergent views on clinician roles and opioid use underscored uncertainties, especially regarding specialist access and prescribing practices. Both groups emphasized the need for education to bridge these gaps, with clearer communication and revised guidelines potentially improving patient outcomes.