Ann Berger, M.D., joined the National Institutes of Health (NIH) in 2000 to launch and manage the Pain and Palliative Care Service at the NIH Clinical Center. She has lectured and published extensively in her field of medical oncology, pain and palliative care, and is senior editor of Principles and Practices of Palliative Care and Supportive Oncology, published in 1998, 2002, and again in 2006. BenchMarks talked with her about her work in pain management.

How did you become interested in the emerging field of palliative care?

When I was 14, I watched my grandfather die of bladder cancer, and my family was overwhelmed by the impact of his illness. I saw firsthand how the effects of disease can ricochet among family members and back to the patient, and I carried those lessons throughout my training as a nurse and then as an oncologist. As a doctor, I came onto the scene just as the palliative care movement was gathering momentum, addressing the many needs of dying patients...

Pain can be a harsh reality of cancer, whether the pain is related to a tumor or caused by treatment of the disease. Some studies show that 30 percent to 50 percent of patients undergoing active treatment for cancer and 70 percent of those with advanced stages of the disease experience significant levels of pain and may be reluctant to discuss their pain with their doctors.