The Role of Pain in Head and Neck Cancer Recurrence and Survivorship

Scharpf, Joseph; Karnell, Lucy Hynds; Christensen, Alan J.; Funk, Gerry F.

doi:10.1001/archoto.2009.107

Cited by 56 publications

(48 citation statements)

References 25 publications

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“…While positive associations were found between depressive symptoms and worst pain, 6,45,47 in this study, higher levels of depressive symptoms were associated with higher pain relief scores. One potential explanation is that our patients with depressive symptoms received antidepressants with analgesic effects.…”

Section: Predictors Of Each Pain Characteristiccontrasting

confidence: 62%

“…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: Predictors Of Each Pain Characteristiccontrasting

confidence: 62%

Section: Discussionmentioning

confidence: 99%

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

View full text Add to dashboard Cite

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“…It is likely that pain and global QOL are associated with death from all causes because both would be expected to increase as individuals' health deteriorates due to life-threatening comorbidities. A previous study 8 has shown that pain reported during the first year following diagnosis is highly correlated with the presence of a recurrence. We can hypothesize only that the lack of such a relationship between these 2 variables and disease-specific survival is due to other variables, such as stage, being stronger, and independent reflections of the increased likelihood of dying from the cancer itself.…”

Section: Commentmentioning

confidence: 91%

Factors Associated With Mortality in 2-Year Survivors of Head and Neck Cancer

Thompson

Pagedar²,

Funk³

2011

Arch Otolaryngol Head Neck Surg

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“…28 As stated by Smit et al 29 most patients with proven recurrent disease report pain complaints as the first symptom which was also observed in the present study. The authors also concluded that each pain complaint after intentional curative treatment should be regarded as a warning sign 29 and may reflect survival rate 30 but however, we can draw any certain conclusions from our study duty to limited sample size in this group of patients. Identifying patients with low QOL may have screening value.…”

Section: Jaisani and Biliga Health Renaissance 2013; Vol 11 (No2);125-mentioning

confidence: 64%

Quality of life and pain prevalence in postoperative patients with oral malignancy- a prospective longitudinal study

Jaisani

Baliga

2013

Health Renaissance

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Background: Epidemiology of pain in oral cancer patients, the effects of curative treatment on this pain, and the impact that the pain experience may have on the patient's quality of life is an overshadowed topic. Methods: A prospective and descriptive study on prevalence of pain, with its impact on quality of life (QOL) was carried out in 36 diagnosed cases of squamous cell carcinoma (SCC) of oral cavity, and were treated with a curative intension. QOL assessment was done using a questionnaire followed by clinical examination at 6months and 12 months post-treatment. Pain was assessed using memorial pain assessment card and pain faces. Results: 42 patients enrolled for this descriptive study but at the end of one year study period only 36 patients completed both the questionnaires. We observed that QOL in our patients, was significantly influenced by mode of soft tissue reconstruction, tongue mobility, speech intelligibility, cosmesis and oral competence. At 6months 16.7% patients reported no pain but at 12months this proportion increased to 52.8%. Severity of pain reduced significantly over time with significant improved pain relief. We observed significant correlation between pain, QOL and mood scale at 12months post-treatment. Conclusion:This study has clarified and statistically confirmed some principles on the residual QOL for patients treated by surgical resection and flap reconstruction for cancer of the oral cavity already presented in the literature. Pain is common among those presenting with curable head and neck cancer. Pain can be reduced by curative treatment.

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The Role of Pain in Head and Neck Cancer Recurrence and Survivorship

Abstract: Because of its association with recurrence and survival, pain within the first year of treatment for head and neck cancer is an important symptom that should be appropriately monitored and managed during routine follow-up.

Cited by 56 publications

References 25 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

Factors Associated With Mortality in 2-Year Survivors of Head and Neck Cancer

Quality of life and pain prevalence in postoperative patients with oral malignancy- a prospective longitudinal study

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