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To the Editor: The article on management of pain for elderly patients with cancer by Dr Bernabei and colleagues¹ focuses attention on an important and often overlooked medical problem: too many elderly patients with cancer—indeed, patients of all ages with cancer—suffer needlessly from unrelieved pain. While Bernabei and colleagues focus on the underuse of pharmacologic agents to control cancer pain, physicians should keep in mind another important palliative tool that is often overlooked: radiation therapy. Research from the Swedish Council on Technology Assessment in Health Care,² the largest study of its kind ever undertaken, found that radiation therapy, although both efficacious and cost-effective, is underused as a means to control pain and improve the quality of life for patients with cancer.

Radiation therapy is particularly effective in treating bone metastases, preventing painful fractures, and shrinking tumors away from other structures.^3-4 In the United States, up to half of all patients . . . [Full Text of this Article]