If one doctor doesn't have the answer, keep looking

When Ann Dosch, 58, of Millersville, Pa., had an exploratory lumpectomy in March 2007, she discovered that she had breast cancer and was treated with another lumpectomy followed by radiation therapy. But when the pain around her incision wouldn't go away and started spreading to her collarbone and shoulder, her surgeon shrugged it off, "He said physical therapy was not going to help me and said 'I don't know why you are having this pain.' I thought, 'I'm never going back to you ever again,'" says Dosch.

Her next stop was the radiation oncologist, who told her that she might have to live with the pain for a couple of years and to take Extra Strength Tylenol. But the pain was getting worse and the Tylenol didn't help.

Dosch got a third opinion from her medical oncologist and this time she found the answer she was looking for, "She told me physical therapy might help. And I was so happy. We both decided it certainly wouldn't hurt." Dosch's doctor also wrote her a prescription for Neurontin.

Dosch held off taking the drug and went to a physical therapist who applied small amounts of pressure to the areas that were hurting her, and gave her exercises to release tightness in the region of her pain. After just one visit, Dosch felt some relief, "I left the first session wanting to cry," says Dosch, "because I felt so relieved that somebody was helping me."

Physician education is catching up
Eugenie Obbens, MD, acting chief of the Pain and Palliative Care Service at Memorial Sloan-Kettering Cancer Center in New York City, blames doctors' neglect of this issue on education, but she believes understanding about the problem is growing.

"Until 10 or 15 years ago there was very little education in oncology textbooks about cancer pain," says Dr. Obbens. "Now there are a lot more books available, more lectures have been given at conferences, pain management is usually covered, there's more action in the hospitals. It's now strongly recommended that each hospital have a pain specialist. Pain has become more visible."

Find a pain specialist
"There are a growing number of pain specialists who have more and more methods to treat pain, like interrupting pain signals," says Timothy Moynihan, MD, a medical oncologist at the Mayo Clinic in Rochester, Minn. "Talk to your oncologist about referring you to a pain clinic; most of the major cancer centers will have them. It takes many, many people to treat pain," says Dr. Moynihan.