The Contribution of Cancer-Specific Psychosocial Factors to the Pain Experience in Cancer Survivors

Jones, Katie Fitzgerald; Magee, L.; Fu, Mei R.; Bernacki, Rachelle; Bulls, Hailey W.; Merlin, Jessica S.; McTernan, Melissa

doi:10.1097/njh.0000000000000965

Cited by 2 publications

References 58 publications

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Further Clarification of Pain Management Complexity in Radiotherapy: Insights from Modern Statistical Approaches

Donati,

Galietta,

Cellini

et al. 2024

Cancers

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Background: The primary objective of this study was to assess the adequacy of analgesic care in radiotherapy (RT) patients, with a secondary objective to identify predictive variables associated with pain management adequacy using a modern statistical approach, integrating the Least Absolute Shrinkage and Selection Operator (LASSO) algorithm and the Classification and Regression Tree (CART) analysis. Methods: This observational, multicenter cohort study involved 1387 patients reporting pain or taking analgesic drugs from 13 RT departments in Italy. The Pain Management Index (PMI) served as the measure for pain control adequacy, with a PMI score < 0 indicating suboptimal management. Patient demographics, clinical status, and treatment-related factors were examined to discern the predictors of pain management adequacy. Results: Among the analyzed cohort, 46.1% reported inadequately managed pain. Non-cancer pain origin, breast cancer diagnosis, higher ECOG Performance Status scores, younger patient age, early assessment phase, and curative treatment intent emerged as significant determinants of negative PMI from the LASSO analysis. Notably, pain management was observed to improve as RT progressed, with a greater discrepancy between cancer (33.2% with PMI < 0) and non-cancer pain (73.1% with PMI < 0). Breast cancer patients under 70 years of age with non-cancer pain had the highest rate of negative PMI at 86.5%, highlighting a potential deficiency in managing benign pain in younger patients. Conclusions: The study underscores the dynamic nature of pain management during RT, suggesting improvements over the treatment course yet revealing specific challenges in non-cancer pain management, particularly among younger breast cancer patients. The use of advanced statistical techniques for analysis stresses the importance of a multifaceted approach to pain management, one that incorporates both cancer and non-cancer pain considerations to ensure a holistic and improved quality of oncological care.

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Further Clarification of Pain Management Complexity in Radiotherapy: Insights from Modern Statistical Approaches

Donati,

Galietta,

Cellini

et al. 2024

Cancers

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Navigating the Shadows: Understanding and Managing Persistent Somatic Symptoms in Cancer Survivors

Bellman

2024

Somatoform Disorders - From Diagnosis to Treatment [Working Title]

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The purpose of this chapter is to provide healthcare professionals, researchers and caregivers with insights on persistent somatic symptoms afflicting cancer survivors. These symptoms, including pain, fatigue, gastrointestinal distress, sexual dysfunction, respiratory issues, and cardiovascular, neurological and musculoskeletal complications often endure long after treatment completion, negatively impacting quality of life. Certain populations like childhood cancer survivors and those receiving intensive chemotherapy have higher somatic symptom burden. Possible mechanisms include accelerated aging, somatization tendencies, treatment side effects, mood disorders, and comorbidities. Assessing patient-reported outcomes and screening tools can facilitate early detection and management. Treatment strategies encompass pharmacological and nonpharmacological modalities targeting specific symptoms. Overall somatic symptom burden correlates with psychological distress and disability among survivors. Tailored, patient-centric rehabilitation programs over the cancer trajectory, from pretreatment through long-term survivorship, can mitigate symptoms. More research on persistent somatic complications is warranted to optimize evidence-based care for survivors’ multifaceted needs.

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The Contribution of Cancer-Specific Psychosocial Factors to the Pain Experience in Cancer Survivors

Cited by 2 publications

References 58 publications

Further Clarification of Pain Management Complexity in Radiotherapy: Insights from Modern Statistical Approaches

Further Clarification of Pain Management Complexity in Radiotherapy: Insights from Modern Statistical Approaches

Navigating the Shadows: Understanding and Managing Persistent Somatic Symptoms in Cancer Survivors

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