Psychological Health Should Be Addressed When Treating Cancer Pain

For patients who experience cancer-related pain, psychological factors such as anxiety and depression symptoms may be affecting their physical wellbeing.

A new study from the Levine Cancer Institute suggests that a patient’s psychological health may directly influence their pain experience. The assessment looked at patient characteristics associated with pain intensity and modifiable psychological factors that may impact a patient’s physical wellbeing.

For the study, patients with cancer at all stages completed a routine tablet-based psychological distress screening at a large academic hybrid, multi-site, community-based cancer institute. Models identified pain predictors from self-reported anxiety, depression, and social support to determine whether the effect of anxiety and depression on pain differed by levels of social support.

The findings showed that patient characteristics of race, lower income, tumor site, and advanced disease were all predictive of pain intensity. Even more, anxiety, depression, and social support were significant factors in influencing pain, and these associations remained after accounting for the other patient characteristics.

Notably, in patients who completed the distress screening 1 year after diagnosis, the level of perceived social support was associated with the effect of anxiety and depression on pain.

The authors noted that there is no way to determine whether the pain results from the cancer, the treatment, or something else. However, the findings suggest that pain may be reduced by certain actions that can help a patients’ psychological health. This includes discussions with patients involving mood, worry, and issues of social support to determine whether these factors can be modified. Improved social support can help mitigate the negative effects of anxiety and depression on pain.

“To my knowledge, this is the largest study to date across all the different variables in cancer pain,” lead author Sarah Kathryn Galloway, PhD, a psychologist at the Levine Cancer Institute, said in a press release. “It emphasizes the need to evaluate psychological symptoms early when addressing cancer pain, which is something that is not assessed regularly and should be. It also underscores the importance of family, interpersonal relationships, and community on pain and illness.”

According to Galloway, the findings demonstrate the need for interdisciplinary, multimodal interventions to help address cancer-related pain.

Reference

Cancer Pain Predicted by Lower Anxiety and Depression, Higher Social Support [news release]. American Society of Clinical Oncology. https://www.asco.org/about-asco/press-center/news-releases/cancer-pain-predicted-lower-anxiety-and-depression-higher. Accessed October 23, 2019.