Cancer-related chronic pain: As cancer patients do better, this becomes increasingly important

http://www.ncbi.nlm.nih.gov/pubmed/21509777

Cancer. 2011 May 1;117(9):1994-2003. doi: 10.1002/cncr.25761. Epub 2010 Nov 18.
Cancer-related chronic pain: Examining quality of life in diverse cancer survivors.
Green CR, Hart-Johnson T, Loeffler DR.

Source
Department of Anesthesiology, University of Michigan, Ann Arbor, Michigan; Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, Michigan; Department of Health Management and Policy, University of Michigan, Ann Arbor, Michigan. carmeng@med.umich.edu.

Abstract
BACKGROUND:
Disparities in cancer survival and pain rates negatively impact quality of life (QOL). This study examines cancer-related chronic pain (CP) and its impact on QOL in diverse cancer survivors.

METHODS:
This survey study focused on current and past pain, health, and QOL in black and white cancer survivors. Participants with breast, colorectal, lung, and prostate cancer and multiple myeloma were recruited through the Michigan State Cancer Registry. Analysis of variance was used to examine outcome differences by pain status, race, and sex. Hierarchical regressions explored predictors for experiencing pain.

RESULTS:
The subjects (N = 199) were 31% black, 49% female, and 57 to 79 years old; 19.5% experienced current pain, and 42.6% reported pain since diagnosis. Women experience more pain (P < .001) and greater pain severity (P = .04) than men. Blacks experienced more pain interference and disability (P < .05). Experiencing pain is related to greater depressive symptoms, poorer functioning, and more symptoms. In hierarchical regressions, female sex predicted pain since diagnosis; pain severity for pain since diagnosis was predicted by black race and female sex.

CONCLUSIONS:
The authors extend the literature by showing that 20% of diverse cancer survivors had cancer-related CP, and 43% had experienced pain since diagnosis, revealing racial and sex disparities in cancer-related CP's incidence and impact on QOL. Having pain was related to poorer QOL in several domains and was more frequently experienced by women. Although black race was not related to pain prevalence, it was related to greater severity. This study reveals an unaddressed cancer survivorship research, clinical, and policy issue. Cancer 2011. © 2010 American Cancer Society.