Pain and Distress in Cancer Patients

Open access

Abstract

Background: A significant number of patients with cancer suffer from anxiety and depressive disorder. Perceived emotional distress, anxiety and depressive symptoms are significantly more frequent in cancer patients with pain than in patients without pain. Despite their high prevalence cancer pain and distress are frequently undertreated.

Material and method: Thirty two oncology patients were included in the study who were receiving concurrent oncologic and pain treatment in the Oncology Clinic TgMures. Patient demographic and clinical information was obtained from medical records and patient report. Patients were screened for pain scores using the Visual Analog Scale and distress scores, using the Distress Thermometer.

Results: The gender proportion of the sample is: 38% female, 62% male. More than 75% of the sample was over 50 years of age, and more than half of the patients (59.3%) had metastatic disease. Significant decreasing trend were seen for pain score difference before and after the pain treatment was reassessed (dosage increase or conversion) (p<0.0001), and decreasing trend seen for distress score (p<0.0001) also.

Conclusions: Pain and distress occurred concomitant in this population. An adequate pain management and pain reassessment contributes to improve the cancer patient emotional distress score, anxiety and depressive symptoms. An accurate screening instrument can facilitate the recognition of patients who needs further assessment and psychiatric treatment.

1. Breivik H, Cherny N, Collett B, et al. Cancer-related pain: A pan-European survey of prevalence, treatment, and patient attitudes. Annals of Oncology. 2009;20:1420-1433.

2. Lesage P, Portenoy RK. Trends in cancer pain management. Cancer Control. 1999;6:126–145.

3. Kelsen DP, Portenoy RK, Thaler HT, et al. Pain and depression in patients with newly diagnosed pancreas cancer. J Clin Oncol. 1995;13:748–755.

4. Portenoy RK. Cancer pain: epidemiology and syndromes. Cancer. 1989;63(Suppl):2298–2307.

5. Warncke T, Breivik H, Vainio A. Treatment of cancer pain in Norway: a questionnaire study. Pain. 1994;57:109–116.

6. Sapir R, Catane R, Strauss-Liviatan N, Cherny NI. Cancer pain: knowledge and attitudes of physicians in Israel. J Pain Symptom Manage. 1999;17:266–276.

7. Levy MH, Chwistek M, Mehta RS. Management of chronic pain in cancer survivors. Cancer J. 2008;14:401–409.

8. World Health Organization. Cancer pain relief and palliative care. Report of a WHO expert committee (World Health Organization technical report series 804). Geneva. Switzerland. World Health Organization, 1990.

9. American Pain Society Quality of Care Committee. Quality improvement guidelines for the treatment of acute pain and cancer pain. JAMA. 1995;274:1874–1880

10. ASCO. Cancer pain assessment and treatment curriculum guidelines. J Clin Oncol. 1992;10:1976–1982.

11. Agency for Health Care Policy and Research. Management of cancer pain. Patient guide. Oncol Nurs Forum. 1994;21:1232–1238.

12. Jacox A, Carr DB, Payne R, et al. Management of cancer pain. Clinical practice guideline. No 9. AHCPR Publication No. 94-0592. Rockville, MD: Agency for Health Care Policy and Research, U.S. Department of Health and Human Services, Public Health Service, March 1994.

13. Carr D, Goudas L, Lawrens D et al. Management of cancer symptoms. Pain, depression and Fatigue. Evidence Report/Technology Assessment no 61. AHRQ Publication no 02-E032.

14. Traeger L, Cannon S, Keating NL, et al. Race by Sex Differences in Depression Symptoms and Psychosocial Service Use Among Non-Hispanic Black and White Patients With Lung Cancer. JCO. 2014;107-113.

15. Levy MH, Chwistek M, Mehta RS. Management of chronic pain in cancer survivors. Cancer J. 2008;14:401–409.

16. Higginson IJ, Murtagh F. Cancer pain epidemiology. In: Bruera E, Portenoy RK (eds). Cancer Pain. Assessment and Management. Vol. 3. Cambridge. Cambridge University Press. 2010;37–52.

17. Portenoy RK, Koh M. Cancer pain syndromes. In: Bruera E, Portenoy RK (eds). Cancer Pain. Assessment and Management, Vol. 4. Cambridge. Cambridge University Press, 2010;53–88.

18. Larue F, Colleau SM, Brasseur L, Cleeland CS. Multicentre study of cancer pain and its treatment in France. BMJ. 1995;310:1034–1037.

19. Caraceni A, Cherny N, Fainsinger R et al. The Steering Committee of the EAPC Research Network. Pain measurement tools and methods in clinical research in palliative care: recommendations of an expert working group of the European Association of Palliative Care. J Pain Symptom Manage. 2002;23:239–255.

20. Serlin RC, Mendoza TR, Nakamura Y, Edwards KR, Cleeland CS. When is cancer pain mild, moderate or severe? Grading pain severity by its interference with function. Pain. 1995;61:277–284.

21. Lussier D, Portenoy RK. Adjuvant analgesic drugs. In: Bruera E, Higginson IJ, Ripamonti C, von Gunten C (eds). Textbook of palliative medicine. London. Edward Arnold Publishers. 2006;402–414.

22. Ripamonti C, Bandieri E. Cancer pain. Crit Rev Oncol Hematol. 2009;70:145–149.

23. Zaza C, Baine N. Cancer pain and psychosocial factors: a critical review of the literature. J Pain Symptom Manage. 2002;24:526–542.

24. Spiegel D, Sands S, Koopman C. Pain and depression in patients with cancer. Cancer. 1994;74:2570–2578.

25. Fishbain DA, Cutler R, Rosomoff HL, Rosomoff RS. Chronic pain-associated depression: antecedent or consequence of chronic pain? A review. Clin J Pain. 1997;13:116–137

26. Farber JM, Weinerman BH, Kuypers JA. Psychosocial distress in oncology outpatients. J Psychosoc Oncology. 1984;2:109–118.

27. Okamura H, Watanabe T, Narabayashi M, et al. Psychological distress following first recurrence of disease in patients with breast cancer: prevalence and risk factors. Breast Cancer Res Treat. 2000;61:131–137.

28. Spiegel D. Psychosocial aspects of breast cancer treatment. Semin Oncol. 1997;24(Suppl 1):S1–S47.

29. Zabora J, Brintzenhofeszoc K, Curbow B, et al. The prevalence of psychosocial distress by cancer site. Psychooncology. 2001;10:19–28.

Acta Medica Marisiensis

The Journal of The University of Medicine and Pharmacy of Targu-Mures

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 96 96 37
PDF Downloads 34 34 15