Smoking Status and Pain Level Among Head and Neck Cancer Patients

Logan, Henrietta L.; Fillingim, Roger B.; Bartoshuk, Linda M.; Sandow, Pamela R.; Tomar, Scott L.; Werning, John W.; Mendenhall, William M.

doi:10.1016/j.jpain.2009.09.006

Cited by 38 publications

(41 citation statements)

References 43 publications

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“…A list of proposed predictors was developed based on a review of the literature on pain in patients with HNC (Table 1). 6,11,15,27,29,35,43,45,47,56 To improve estimation efficiency and to construct parsimonious models, exploratory analyses were performed in which each potential predictor was assessed to determine whether it would result in a better fitting model if it alone was added as a level 2 predictor. Predictors with a t value of ,2, which indicates a lack of significant effect, were dropped from subsequent model testing.…”

Section: Discussionmentioning

confidence: 99%

“…Findings on the association between pain intensity and the receipt of chemoradiotherapy were not consistent. 11,15,27,35 Among 3 crosssectional 29,43,56 and 3 longitudinal 6,45,47 studies that evaluated pain after HNC treatment, higher pain intensity scores were associated with younger age, 43,45 older age, 6 less education, 47 smoking, 29 surgery combined with RT, 56 neck dissection, 47 higher RT doses, 6 feeding tube, 47 xerostomia, 47 difficulty with speech or swallowing, 6 pretreatment pain, 47 use of pain medication, 47 worse physical and mental health, 45 less activity, 47 sleep problems, 47 and depressive symptoms. 6,45,47 None of these studies evaluated all of these characteristics in the same sample or whether they predicted changes in pain scores across the treatment trajectory.…”

Section: Introductionmentioning

confidence: 99%

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Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy

Astrup

Rustøen

Miaskowski

et al. 2015

Pain

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Pain is a common symptom in patients with head and neck cancer (HNC) that is associated with significant decrements in physical and psychological functioning. Only 4 studies have evaluated for changes in and predictors of different pain characteristics in these patients. In this longitudinal study of patients with HNC, changes in pain intensity (i.e., average pain, worst pain), pain interference with function, and pain relief were evaluated from the initiation of radiotherapy and through the following 6 months. Hierarchical linear modeling was used to evaluate for changes over time in these 4 pain characteristics, as well as to identify predictors of interindividual variability in each characteristic. Overall, pain intensity and interference with function scores were in the mild-to-moderate range, while pain relief scores were in the moderate range. The occurrence of pain, as well as scores for each pain characteristic, increased from the initiation to the completion of radiotherapy, followed by a gradual decrease to near pretreatment levels at 6 months. However, interindividual variability existed in patients' ratings of each pain characteristic. Predictors of more severe pain characteristic scores were more comorbidities, worse physical functioning, not having surgery before radiotherapy, difficulty swallowing, mouth sores, sleep disturbance, fatigue, more energy, and less social support. Patients with more depressive symptoms had better pain relief. Although some of the predictors cannot be modified (e.g., rrence of surgery), other predictors (e.g., symptoms) can be treated. Therefore, information about these predictors may result in decreased pain in patients with HNC.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy

Astrup

Rustøen

Miaskowski

et al. 2015

Pain

View full text Add to dashboard Cite

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“…Tobacco use has been temporally associated with pain severity, 11, 12 and problem drinking has been associated with pain. 13 Diet and physical activity also influence physical pain among cancer patients.…”

Section: Introductionmentioning

confidence: 99%

Predictors of Pain Among Patients With Head and Neck Cancer

Shuman¹,

Terrell²,

Light³

et al. 2012

Arch Otolaryngol Head Neck Surg

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Objective Pain is a strong contributor to cancer patients’ quality of life. The objective of this study was to determine predictors of pain 1 year after the diagnosis of head and neck cancer. Design Prospective, multi-site cohort study. Setting Three academically-affiliated medical centers. Patients Previously untreated patients with carcinoma of the upper aerodigestive tract (n=374). Main Outcome Measures Participants were surveyed pre-treatment and 1 year thereafter. Multivariate analyses were conducted to determine predictors of the SF-36 bodily pain score 1 year after diagnosis. Results The mean SF-36 bodily pain score at 1 year was 65, compared to 61 at diagnosis (p=.004), compared to 75 among population norms (lower scores indicate worse pain). Variables independently associated with pain included pre-treatment pain score (p<0.001), less education (p=0.02), neck dissection (p=0.001), feeding tube (p=0.05), xerostomia (p<0.001), depressive symptoms (p<0.001), taking more pain medication (p<0.001), less physical activity (p=.02), and poor sleep quality (p=0.006). Current smoking and problem drinking were marginally significant (p=0.07 and 0.08, respectively). Conclusions Aggressive pain management may be indicated for head and neck cancer patients who undergo neck dissections, complain of xerostomia, require feeding tubes, and have medical comorbidities. Treatment of modifiable risk factors such as depression, poor sleep quality, tobacco and alcohol abuse may also reduce pain and improve quality of life among head and neck cancer patients.

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“…30 However, smoking rates among CaB patients are representative of rates of patients with other malignancies. 26,27 While giving a cancer diagnosis is considered by many to be a "teachable moment" to counsel smoking cessation strategies, unfortunately 76% of patients who had been active smokers at the time of diagnosis (n = 33) reported smoking at some point after their diagnosis and 58% continued to smoke at the time of assessment. Ostroff and colleagues investigated a population 12 years ago using a similar inclusion criteria and published somewhat more optimistic results; their patients, however, were assessed slightly longer after their diagnosis on average and therefore had more opportunity to quit.…”

Section: Discussionmentioning

confidence: 99%

A smoking cessation program as a resource for bladder cancer patients

Vilensky

Lawrentschuk

Hersey

et al. 2012

CUAJ

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Background: Continued tobacco use following a bladder cancer (CaB) diagnosis puts patients at risk for other tobacco-associated diseases and has also been associated with heightened risks of treatment-related complications, tumour recurrence, morbidity and mortality. Our aim was to determine if patients with CaB who continue to smoke warrant a smoking cessation program as a resource for improving their prognosis and long-term health. Methods: A cross-sectional quantitative questionnaire-based study was performed between January and April 2009. We surveyed patients with a pathologically confirmed diagnosis of CaB during their cystoscopy appointments at a single cancer centre. Results: One hundred patients completed the survey with 72% of them admitting to smoking in their lifetime. A third of respondents smoked at the time of their diagnosis; 76% of patients who had been active smokers at the time of their diagnosis (n = 33) reported smoking at some point thereafter and 58% continued to smoke. Among continued smokers, they were classified in the following categories: 26% were in "precontemplation," 5% in "contemplation," 16% in "preparation," and 53% in "action;" 37% of patients who continued to smoke were interested in a hospital-based smoking cessation program. Overall, 70% reported smoking as a risk factor for a poor CaB prognosis. The two most common barriers to quitting were "trouble managing stress and mood" and "fear of gaining weight." Conclusion: Based on the data from our centre, patients with CaB who continue to smoke after their diagnosis warrant a smoking cessation program as a resource for improving prognosis and long-term health. Further research should focus on establishing an efficacious and cost-effective program that provides these patients with the resources they need to quit smoking. RésuméContexte : L'usage continu du tabac après un diagnostic de cancer de la vessie fait courir aux patients un risque de contracter d'autres maladies associées à l'usage du tabac, et a aussi été associé à des risques accrus de complications liées au traitement, de récurrence de la tumeur, de morbidité et de mortalité. Notre but était de déter-miner si les patients atteints de cancer de la vessie qui continuent de fumer ont besoin d'un programme d'abandon du tabac pour améliorer leur pronostic et leur santé à long terme. Méthodologie : Une étude transversale quantitative par questionnaire a été réalisée entre janvier et avril 2009. Nous avons sondé des patients ayant reçu un diagnostic de cancer de la vessie confirmé par examens pathologiques pendant un rendez-vous pour cystoscopie dans un seul centre de traitement du cancer. Résultats : Cent patients ont rempli le sondage, dont 72 % qui ont avoué avoir fumé pendant une période de leur vie. Un tiers des répondants fumait au moment du diagnostic; 76 % des patients qui étaient des fumeurs actifs au moment de leur diagnostic (n = 33) ont signalé avoir continué à fumer par après et 58 % fumaient toujours. Ceux qui continuaient à fumer ont été répartis dans l...

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Smoking Status and Pain Level Among Head and Neck Cancer Patients

Cited by 38 publications

References 43 publications

Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy

Changes in and predictors of pain characteristics in patients with head and neck cancer undergoing radiotherapy

Predictors of Pain Among Patients With Head and Neck Cancer

A smoking cessation program as a resource for bladder cancer patients

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