Surviving cancer may also mean surviving pain, according to a study by the University of Michigan Health System showing 20 percent of cancer survivors at least two years post diagnosis have current cancer-related chronic pain.

The study, published online ahead of print in the American Cancer Society's journal Cancer, gives new insight on issues in cancer survivorship among the growing number of U.S. cancer survivors.

More than 40 percent of patients surveyed had experienced pain since their diagnosis, and the pain experience was worse for blacks and women.

The Lance Armstrong Foundation, an organization that examines experiences of the cancer community, sponsored the U-M survey study of nearly 200 patients.

Other findings:

- The most significant source of pain was cancer surgery (53.8 percent) for whites and cancer treatment (46.2 percent) for blacks.

- Women had increased pain, more pain flares, more disability due to pain, and were more depressed than men because of pain.

- Blacks with pain reported higher pain severity, expressed more concern about harmful pain treatment side effects, and had greater pain-related disability.

According to the National Cancer Institute, more than 60 percent of people diagnosed with cancer will be alive in five years. As society ages, study authors say, pain complaints and cancer issues will grow as significant health concerns and health policy issues.

"All in all, the high prevalence of cancer and pain and now chronic cancer pain among these survivors, especially blacks and women, shows there's more work to be done in improving the quality of care and research," says lead study author and pain medicine specialist Carmen R. Green, M.D., professor of anesthesiology, obstetrics and gynecology and health management and policy at the University of Michigan.

Patient and physician knowledge and attitudes may lead to poor pain management, authors say. For instance, worries about side effects such as addiction or fears that pain is a sign that the cancer had gotten worse may lead patients and their doctors to minimize pain complaints.

"When necessary and appropriate there are a variety of therapies available to address pain and improve their well-being," Green says.

Green co-authored the study with U-M colleagues Tamera Hart-Johnson, M.S., and Deena R. Loeffler, M.A.

Study details: Adults, ages 18-90, who experienced breast, prostate, colorectal, or lung cancer, or multiple myeloma at least two years prior were part of the study data. Participants were recruited from the Michigan State Cancer Cancer Registry. Participants were defined as survivors from the moment of diagnosis, in accordance with the NCI and the Lance Armstrong Foundation.

Reference: "Cancer-related chronic pain: examining quality of life in diverse cancer survivors," Cancer.