Behavioral assessment of head and neck cancer pain

Keefe, Francis J.; Brantley, Alton; Manuel, Gerdenio; Crisson, James E.

doi:10.1016/0304-3959(85)90002-8

Cited by 40 publications

(11 citation statements)

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“…Connelly and Schmidt studied pain levels in newly diagnosed and treated oral cancer patients [9]; similar to our findings, they found little association between stage (e.g., tumor size) and pain levels. Although our findings and those of others [29] are based on assessing pain at different time points in the lives of the cancer patient, it supports our contention that the presence of pain is a serious concern to those diagnosed with and surviving head and neck cancer.…”

Section: Discussionsupporting

confidence: 87%

Metallic taste phantom predicts oral pain among 5-year survivors of head and neck cancer

Logan

Bartoshuk

Fillingim

et al. 2008

Pain

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Chronic pain following cancer-related treatment is emerging as a major concern. Heretofore, the pain level among 5-year survivors of head and neck cancer has received limited attention. This study proposes a predictive model for understanding factors associated with elevated levels of chronic oral pain. Cancer survivors were drawn from a pool of 5-year survivors. A listed sample matched on sex, age, and zip code was purchased and served as a comparison group. Telephone interviews were conducted by a professional call center. Oral pain levels and the presence of metallic taste phantoms were significantly higher in the cancer survivor group than among the comparison group. The prevalence of chronic oral pain among the 5-year survivors was 43% compared to 13% for the comparison group. Hierarchical linear regression showed that among the 5-year survivors, the predictive model for spontaneous pain accounted for 24% of the variance, and for function-related pain the model accounted for 34% of the variance, with the presence of a phantom metallic taste making a significant independent contribution in both models. In the function-related pain model, depression and level of oral function quality of life (QOL) made significant independent contributions. The presence of oral pain is a significant problem among head and neck cancer survivors. The presence of metallic phantoms is an important new piece of evidence suggesting neural damage following cancer-directed treatment. Routine assessment of oral pain levels could improve current analgesic approaches among head and neck cancer survivors.

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Section: Discussionsupporting

confidence: 87%

Metallic taste phantom predicts oral pain among 5-year survivors of head and neck cancer

Logan

Bartoshuk

Fillingim

et al. 2008

Pain

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“…According to some authors, head and neck cancer patients have difficulty self-reporting pain to their medical care givers. 28 Others have shown that assessment and management of cancer pain by medical staff is often less than optimal. 29 Patients therefore manage their own pain and investigation indicates that treatment is often inadequate.…”

Section: Discussionmentioning

confidence: 99%

“…29 Patients therefore manage their own pain and investigation indicates that treatment is often inadequate. 28 This article shows that 50% of patients with head and neck cancer have pain that can be reduced by curative treatment. There remains a percentage of disease-free patients who continue to have ongoing mild to moderate pain that may impact adversely on their QL.…”

Section: Discussionmentioning

confidence: 99%

A prospective, longitudinal study of pain in head and neck cancer patients

1999

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Background Little is known about the epidemiology of pain in head and neck cancer, the effects of curative treatment on this pain, and the impact that pain experience may have on patients' quality of life (QL). Method The prevalence and severity of pain was studied in 93 patients who were first seen with a diagnosis of head and neck cancer, were treated, and remained disease free at two years. QL assessment utilised the life‐satisfaction scale and the General Health Questionnaire as specific measures. Pain was assessed by a linear analogue scale anchored by words and numbers. Results Forty‐eight percent had head and neck pain when first seen, whereas only 25% and 26% had such pain at 12 and 24 months. Approximately 8% of patients rated the pain as “severe” when first seen, whereas 3% had severe pain at 12 months and 4% at 2 years. The prevalence of shoulder and arm pain increased from 14% at diagnosis to 37% at a year and 26% at 24 months, but the percentage of patients with severe pain at any stage postoperatively was only 5% and 2%, respectively. Any pain (pain in either in the head and neck or shoulder and arm or both) at 2 years was strongly predicted by earlier posttreatment pain (at 3 months or at 12 months.) Shoulder and arm pain at 2 years was strongly correlated with surgical treatment of the neck, although no difference in pain experience was noted between those who had radical neck dissections and those who had more conservative procedures. There was no correlation between radiotherapy to the neck and subsequent shoulder and arm pain. Pain had an adverse effect on the general well‐being and psychological distress of head and neck cancer patients who were free of disease. Conclusions Pain is common among those presenting with curable head and neck cancer. Pain can be reduced by curative treatment but neck dissection may cause increased shoulder and arm pain. Ongoing pain is predictable and impacts adversely on patients QL. © 1999 John Wiley & Sons, Inc. Head Neck 21: 531–537, 1999.

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“…We have also used structured situations to sample pain in a variety of other chronic pain populations, including patients with osteoarthritis , rheumatoid arthritis (Anderson et al, 1987), or head and neck cancer (Keefe et al, 1985). Data from these studies have provided additional support for the reliability, validity, and utility of such observation methods.…”

Section: Pain Measurement Methodsmentioning

confidence: 99%