Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls

Abstract

Background The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes. Methods An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s d and Hedge’s effect size, as appropriate. Results The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (p < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (p < 0.05). Conclusion Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.

From a Clustering of Adverse Symptoms after Colorectal Cancer Therapy to Chronic Fatigue and Low Ability to Work: A Cohort Study Analysis with 3 Months of Follow-Up

“…The pain cluster consisted of pain, abdominal pain, buttock pain, bloating, and dysuria. Pain is one of the symptoms present at the time of the diagnosis and before treatment and can often be aggravated by subsequent treatments [ 37 ]. Oxaliplatin-induced neuropathy has emerged as a common side effect of chemotherapy for CRC patients [ 38 ].…”

“…Longitudinal Association of Baseline Symptoms with Fatigue 150 (54%) study participants had clinical fatigue (FACIT-F-FS < 34 points) at baseline and n = 82 (29.3%) at 3-month follow-up. The median FACIT-F-FS increased from 31 points (interquartile range (IQR): 22-42) to 40 points (IQR:[29][30][31][32][33][34][35][36][37][38][39][40][41][42][43][44][45][46][47] in this time, which translates to less fatigue. On average, the mean FACIT-F-FS improved by 5.9 points (standard deviation (SD): 9.7 points).…”

The Impact of Palliative Care on Mitigating Pain and Its Associated Effects in Determining Quality of Life among Colon Cancer Outpatients

“…The term "chronic primary pain" is used in some circumstances where pain may be regarded as a sickness. However, in some instances, such as with chronic cancer-related pain, pain is a complication of an underlying illness [14].…”