Chronic Pain vs. Cancer Pain: Pain is Pain

I have pain from my cancer therapy, mCRPC. It seems that every side effect from Lupron and Casodex, used to treat Prostate Cancer, has either hit me with a vengeance or aggravated an existing condition . . . specifically arthritis. I filed for SSDI in 2007 and was approved later that year.

My wife, A, suffers from CP, specifically DDD, Foraminal stenosis, ruined shoulder rotator cuff, arthritic knees, and more. She filed for SSDI in 2006 and was approved in 2008.Just the difference in time to gain approval for SSDI speaks volumes about how society views CP.

I saw a post on this forum yesterday that mentioned this discrimination, " of course everybody knows that only cancer causes CP". This post in no way denigrated cancer patients just the difference in the treatment of the two causes of pain. Given my position, I see first hand these differences: #1 under medication of CPs and willful over medication of cancer folks #2 condescending treatment of CPs by med staff and Drs. While we are treated like human beings in pain #3 open apps. For Drs. CPs wait while we don't #4 suspicious treatment by pharmacy staff for CPs while we are treated, once again, like human beings in pain.

I could go on and on but I'm sure y'all have a special one I've forgotten. All of this dates back to Nixons "War on Cancer" back in 1971. This has elevated cancer to some sort of exhalted status that suddenly divided it from other as painful maladies. I'm old enough to remember the days when arthritis was feared every bit as much as cancer but those days are gone . . . Q

Very insightful answer, as usual WB. I agree that oncologists are the absolute best at treating pain. Whether it's the closeness they have with their patients I'm not sure. I think a lot of it has to do with the diagnostic reality of cancer pain plus the fact that they don't have med. Boards and the DEA limiting the type and amount of drugs they can Rx. So much of CP is soo hard to pin down that the PMDs don't even trust their own Dxs. In consequence you get under medication. When they develop a tricorder that can be waved over a CPs body to measure their pain level then we'll see some decent pain treatment.
I think that surgeons make the worst PMDs as they must have a little sadistic streak in them to be able to do what they do. Just kidding, a little, though surgeons need that pain feedback to let them know how the healing process is going.
I know one thing, cancer patients make good pain patients. They are like the people on this unusually clean med board. Just wanting the least amount of meds to live a close to normal life. I know that since I have a shortened life span I don't want it to be spent in a drugged haze and most cancer patients feel the same. At first, in my Denial stage, I wanted all the pain to be gone and was medicated to do as close to that as possible. Further down the road I hated the meds side effects and so I tapered off till I'm at 20% of peak medication and I feel great.
This wanders a bit but I hope my point shines through . . . That responsible CPs should be treated like cancer patients, let them titrate themselves to achieve the persons desired level of pain control, if they go to high I can assure you that they will take themselves back down . . . Q

Good point, lumiere,
Given pains difficulty to measure objectively PMDs do have a rough time quantifying the amount of drugs they should Rx. That is why I feel that after a CP patient has proven their responsibility they should be allowed to walk into their PMs office and request a change of whatever kind, up, down, and type . . . then discuss this change and give it a try. That's how I am treated by my MO and I haven't needed to make a change in my meds for over 3 years.
The pain meds Fentanyl and it's IR cousin Fentora are meant to bet it rated by the patient, it says exactly that in the PI. However, few PMs feel comfortable with that and fewer CPs are aware of it. This is why one of the best meds out their is usually not Rxed. I've read several posts here that complain about the efficacy of their patches . . . They don't last long enough, they are either too strong or not strong enough but the atmosphere in a typical PMs office is such that the patient sits while the Dr. Prescribes, no true rapport is achieved . . . Q

It's a good point, However, my RA gets treatment from people like cancer, for some reason when I say I have RA it's oh, yeah they totally understand and again it's another one of those elevated illnesses...But you have to say RA not Arthritis, if I say arthritis it's downplayed again...But if you say RA its like "wow, so sorry"...

It's all in the wording and the disease you have, Of course nothing is worse than Cancer and that is a given.

There are a few other diseases than get the sympathic ear as well like MS, and ALS or MD (can't spell this one, but the telethon for it is coming up) So there are a few, but none as scary as cancer.

However, Cancer also has the fear stigma and people will fear to even touch you...

It's silly none the less to treat any illness without the compassion it deserves...

Some have said that a cancer patient prays to live. A chronic pain patient prays to die.