With greater emphasis on palliative (comfort) care, and increased knowledge about pain control, it is becoming easier for patients with pain to get the relief they are entitled to. However there are still some barriers to good pain management that you may need to overcome as you learn to be a better advocate for yourself.

What are some of these barriers?

Health care professionals may not all have adequate knowledge about pain control, as it traditionally has not been a top priority in the health care system. Talking with your doctor about your pain and perhaps requesting a consult with a clinician that is a specialist in pain management may get you on the right track.

People with cancer are sometimes reluctant to discuss their pain.

Do any of these statements sound familiar to you?

* You have the wish to be a "good" patient, one who doesn't complain. Doctors want to help you feel the best you can, and improve the quality of your life. They cannot do this unless you share with them your experience of pain.

* You fear addiction to pain medication. People do NOT get addicted or "high" from pain medication. Even some health care professionals may still think this is the case, which is a signal to get another opinion from a pain specialist.

* You worry about the side effects from taking more medications. Most side effects can be managed, click here for more information.

* You are afraid that if you use medication over a long period of time it will stop working. If tolerance develops, your doctor can safely increase your dosage, prescribe a different drug, or use a combination of drugs.

* You are not certain how to describe your pain. It helps to write down where your pain is, when it starts, and what helps you feel better, so you can tell your doctor exactly what is happening. For more information click here.

* You may fear that your pain means your disease has worsened, which is too frightening to face. Remember pain does not necessarily mean your cancer is worse. You will have more energy to fight your cancer if your pain is controlled.

Our health care system sometimes contributes to the barriers against good pain management. For example:

* Sometimes insurance companies may not reimburse for the most appropriate treatments, or you may lack insurance, and pain management may be too costly for you to afford without it. You should make your doctor aware of any financialconsiderations, as he/she may be able to prescribe an equally effective treatmentthat costs less. Going through the appeals process at your insurance company also may help, so be persistent! Another good resource is a hospital or community social worker that can provide information on local resources. Also, most pharmaceutical companies have assistance programs for people who cannot afford medications. See a local social worker or call the Cancer Care Counseling Line at 1-800-813-HOPE.

Laws restricting and regulating controlled substances (narcotics) may interfere with a doctor's ability and willingness to prescribe pain medications. State laws vary greatly and sometimes restrict doctors in ways the federal government does not, making health care professionals reluctant to prescribe controlled substances for fear of losing their license. Many states now have state pain initiatives which are working with the state governments to identify and remove legal barriers to use of controlled substances for cancer pain. Contacting your state representative and voicing your concern for this issue will help them better understand its importance.