WASHINGTON (AP) -- Cancer patients often suffer needlessly because the nation's medical system does a poor job of treating pain that is a common part of the disease, according to experts who produced a study for the National Institutes of Health.

"Cancer-related pain, depression and fatigue are undertreated and this situation is simply unacceptable," said Dr. Donald Patrick, a medical professor at the University of Washington, Seattle, and chairman of the committee.

"We have to move to the point that patient comfort and care are a part of the cancer treatment agenda," said Dr. Andrew T. Turrisi III, a radiation oncologist at the Medical University of South Carolina, Charleston. "Some patients are more fearful of pain than they are of death itself."

"Optimal pain relief for cancer patients needs to be a minimally accepted standard," the committee statement said. "Inadequately treated pain can be considered one indicator of poor quality of care."

The report was written after the 13-member panel analyzed a series of studies over a two-day period at a conference organized by the NIH.

At a news conference where the report was released, Patrick said the group found that many doctors lack the knowledge of how to control relentless pain and that medical schools fail to provide adequate training in pain management.

"The educational process needs to be rethought," said Patrick. "Students, trainees and post graduates all need additional training in management, assessment and treatment of pain."

There are also official barriers to bringing relief to suffering patients, the panel said.

Dr. Paul S. Frame, a professor at the University of Rochester School of Medicine in New York and a member of the committee, said some government regulations require a three-copy report each time a doctor prescribes some opiates commonly used for cancer pain relief.

"Sometimes practitioners don't want to go to the hassle of prescribing a triplicate drug," he said. "They may use something less effective instead."

Even the day of the week can block pain relief for cancer patients, said L. Douglas Ried, a professor at the college of pharmacy, University of Florida, Gainesville.

Ried said regulations require that a patient get a new prescription for some opiates used for pain relieve. If, for instance, a patient runs out of morphine on a weekend, "it is very difficult for him to get another prescription" because his doctor is not available and a pharmacist is not allowed to sell more of the drug without a doctor's approval.

"Sometimes pharmacists will fill the prescription and then call the doctor on Monday, but they are putting their license at risk," said Ried. "Most pharmacists, though, follow the regulations to the letter," which leaves the patient still in pain.

Even the size of the pain problem is uncertain, the committee said. The report estimated that there are nearly 9 million people in the United States with a history of cancer, with about 1.3 million additional patients diagnosed each year. About 60 percent of these patients will live at least five years.

The committee said some researchers studying pain management said that only about 14 percent of cancer patients have persistent pain. Other studies found that relentless pain affected virtually every cancer patient. The most common estimates found that pain was poorly controlled in 26 to 41 percent of all cancer patients.

One obstacle to measuring the scope of the problem is that patients, themselves, often give their doctors poor insight into their pain, with some believing that it is just part of the cancer experience and must be tolerated.

"They sometimes feel there is not much that can be done about it," said Frame.

Other patients have an unrealistic fear about opiates and often choose to suffer instead of asking for the drugs, he said.

"There is a feeling that the drugs are bad," said Frame. "They are worried about addiction. People don't want to become junkies."

Copyright 2002 The Associated Press. All rights reserved.