Symptom Burden Among Cancer Survivors: Impact of Age and Comorbidity

Abstract

Background: Previous research among specific cancer populations has shown high but variable symptom burden; however, very little is known about its extent and pattern among the entire population of US cancer survivors, which is more clinically relevant to primary care physicians.Methods: To determine the prevalence of ongoing symptom burden among cancer survivors and compare it with the general population without cancer, we analyzed data from the 2002 National Health Interview Survey, which included 1,904 cancer survivors and 29,092 controls. Main outcome measures included self-reported ongoing pain, psychological distress, and insomnia. Multivariate logistic regression models were used to adjust for confounders and test for interactions.Results: The rates of ongoing pain, psychological distress, and insomnia among cancer survivors were 34%, 26%, and 30%, respectively, and were significantly higher (all P < .001) than controls without a history of cancer (18%, 16%, and 17%). Compared with controls in the same age groups, younger survivors (younger than 50) were much more likely to report ongoing symptoms than older survivors (older than 64); adjusted odds ratios were 2.96 and 1.36 for pain in the respective age groups (P < .001). Comorbidities also interact with cancer status and contribute to a marked increase in reports of ongoing symptom burden among cancer survivors, with a greater number of comorbidities leading to greater degree of symptom burden in a dose-dependent manner (P < .001).Conclusions :

Neuroinflammation and Comorbidity of Pain and Depression

“…Comorbid depression and pain occur within clinical settings with extremely high prevalence, whereby patients present with chronic levels of inflammation, such as with rheumatoid arthritis and cancer (Gureje et al, 1998;Rakoff-Nahoum, 2006;Reyes-Gibby et al, 2006;Isik et al, 2007;Mao et al, 2007). Such high co-occurrence of pain and depression in the context of inflammation is suggestive of a commonality of mechanisms.…”

Psychological and Behavioral Approaches to Cancer Pain Management

“…Younger survivors seem to be particularly vulnerable to higher levels of pain after treatment. 40 Most research on pain in survivors has involved women who have completed treatment for breast cancer. In these women, higher levels of pain catastrophizing and fear of recurrence are associated with increased pain, most notably for postmastectomy pain.…”

Cancer and insomnia

“…nın çalışmasında insomnia, ağrı ve psikolojik problemlerle olan ilişkisi kanser hastaları ve kanser tanısı olmayan kontrol grubu ile karşılaştırılmıştır. [40] Beklenildiği üzere kanser hastalarındaki sıklığı daha yüksek saptanmıştır. Derlemenin başlangıcında da değinildiğimiz gibi insomnia kanser hastalarında tek bir semptomdan ziyade semptom kümesi olarak karşımıza çıkmaktadır.…”