Lifestyle and Pain following Cancer: State-of-the-Art and Future Directions

Abstract

This review discusses chronic pain, multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, and the relationship between these lifestyle factors and pain after cancer. Chronic pain is known to be a common consequence of cancer treatments, which considerably impacts cancer survivors’ quality of life when it remains untreated. Improvements in lifestyle behaviour are known to reduce mortality, comorbid conditions (i.e., cardiovascular diseases, other cancer, and recurrence) and cancer-related side-effects (i.e., fatigue and psychological issues). An inadequate stress response plays an important role in dysregulating the body’s autonomic, endocrine, and immune responses, creating a problematic back loop with pain. Next, given the high vulnerability of cancer survivors to insomnia, addressing and treating those sleep problems should be another target in pain management due to its capacity to increase hyperalgesia. Furthermore, adherence to a healthy diet holds great anti-inflammatory potential for relieving pain after cancer. Additionally, a healthy diet might go hand in hand with weight reduction in the case of obesity. Consuming alcohol and smoking have an acute analgesic effect in the short-term, with evidence lacking in the long-term. However, this acute effect is outweighed by other harms on cancer survivors’ general health. Last, informing patients about the benefits of an active lifestyle and reducing a sedentary lifestyle after cancer treatment must be emphasised when considering the proven benefits of physical activity in this population. A multimodal approach addressing all relevant lifestyle factors together seems appropriate for managing comorbid conditions, side-effects, and chronic pain after cancer. Further research is needed to evaluate whether modifiable lifestyle factors have a beneficial influence on chronic pain among cancer survivors.

The Key Role of Lifestyle Factors in Perpetuating Chronic Pain: Towards Precision Pain Medicine

“…In addition, another review included in this Special Issue focusses on patients with post-cancer pain, and argues that diet/nutrition might be ready to transition from a cancer recurrence/prevention strategy towards a chronic pain management modality for cancer survivors [ 24 ]. The importance of evidence-based pain management in cancer survivors is another global trend thoroughly addressed in this Special Issue, with another state-of-the-art review discussing how multiple modifiable lifestyle factors, such as stress, insomnia, diet, obesity, smoking, alcohol consumption and physical activity, play a role in shaping the pain experience after cancer, and how available treatment programs for cancer survivors can be improved by including an individually tailored lifestyle management approach [ 25 ].…”

“…The resulting multimodal approach for managing patients with chronic pain implies tailoring treatment to the individual patient characteristics and therefore fits into the global move towards precision medicine [ 2 ]. Evidence supporting such a paradigm shift from a tissue- and disease-based approach towards individually tailored multimodal lifestyle interventions for chronic pain is mounting [ 4 , 12 , 23 , 25 ], but further study is needed. Several papers included in this Special Issue highlighted key areas for future research in this area (e.g., [ 4 , 25 ]).…”

“…Evidence supporting such a paradigm shift from a tissue- and disease-based approach towards individually tailored multimodal lifestyle interventions for chronic pain is mounting [ 4 , 12 , 23 , 25 ], but further study is needed. Several papers included in this Special Issue highlighted key areas for future research in this area (e.g., [ 4 , 25 ]). Such research efforts hold the potential to improve outcomes and decrease the psychological and socioeconomic burden of chronic pain.…”

Establishing an Expert Consensus on Key Indicators of the Quality of Life among Breast Cancer Survivors: A Modified Delphi Study

“…In developed countries, the mortality rate has declined significantly in recent years, due to improved screening, early diagnosis, and treatment programs [ 3 , 4 ]. Most patients seem to adjust well; however, over time, cancer survivors often start to suffer from decreased well-being [ 5 , 6 ]. The need to focus more on the QoL of cancer survivors is recognized by the EU Beating Cancer Plan [ 7 ], which supports the shift in focus from “‘how long’ people live after diagnosis, rather to ‘how well and how long’ they live” [ 6 ] (p. 21), and is recognized as one of the most important intervention areas to focus on by the European Commission’s Mission Board for Cancer [ 8 ].…”

Exploring healthcare providers’ perceptions regarding the prevention and treatment of chronic pain in breast cancer survivors: A qualitative analysis among different disciplines

“…Pharmacologic interventions often seem to have limited efficacy in resolving chronic pain in these instances [16][17][18][19]. The past years, more attention has also been given to a biopsychosocial approach of pain in cancer and cancer survivorship [20,21]. The prevention and treatment of chronic pain in cancer survivors also require a multimodal care plan with pharmacologic, as well as behavioural interventions [22].…”