Published in the September 2012 Newsletter

Pain remains a paramount issue in outpatient cancer care in the US, with two-thirds of patients at risk of pain reporting actually having pain or receiving analgesic treatment, according to the results of the first publication using data from the Symptom Outcomes and Practice Patterns (SOAPP) study.

SOAPP (also known as E2Z02) was an observational study undertaken by ECOG’s Symptom Management Committee and Patient Centered Outcomes and Survivorship Committee to explore pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. The article, published online ( ahead of print on April 16, 2012 by the Journal of Clinical Oncology, reported that about one-third of patients who had pain or used analgesics were undertreated for their pain and that only about one-third of the undertreated patients were adequately treated over 1 month of follow-up.

The study also found a significant disparity in pain treatment adequacy, with the odds of inadequate analgesic prescribing two times higher in minority patients than non-Hispanic white patients.

“These findings related to racial disparity in this study of over 3000 patients represent a critical observation,” says lead author Michael J. Fisch, MD, MPH, FACP, FAAHPM, Chair of the Department of General Oncology at the University of Texas M.D. Anderson Cancer Center (Houston, TX) and Chair of the ECOG-ACRIN Symptom Management Committee. “These data awaken us to a major opportunity in healthcare to work harder and smarter to improve cancer pain care for all patients and to resolve this striking disparity.”

Complete author list:  Michael J. Fisch, Ju-Whei Lee, Matthias Weiss, Lynne I. Wagner, Victor T. Chang, David Cella, Judith B. Manola, Lori M. Minasian, Worta McCaskill-Stevens, Tito R. Mendoza, and Charles S. Cleeland.

Citation: Fisch MJ, Lee J-W, Weiss M, et al. Prospective, observational study of pain and analgesic prescribing in medical oncology outpatients with breast, colorectal, lung, or prostate cancer. J Clin Oncol. 2012;30(16):1980-1988.

Related editorial citation: Martin R. Stockler and Nicholas R.C. Wilcken. Why is management of cancer pain still a problem? J Clin Oncol. 2012;30(16):1907-1908

Read the article abstract

Read the related editorial

View an ABC News segment Cancer Patients’ Pain Remains Undertreated, with Dr. Fisch

To learn more about SOAPP, including the opportunity for researchers to access SOAPP data to support future cancer research, visit the official SOAPP website:

Trial Registration at NCT00303914