Advanced disease, depression intensify pain distress among cancer patients

Cancer patients with more advanced diseases, and those with higher anxiety and depression burdens, suffer from greater pain distress, a recent study has found.

The study included 1,103 cancer patients (mean age, 59.9±12.3 years; 54.7 percent female) who underwent biopsychosocial distress screening before starting treatment. Pain distress, anxiety and depression were measured according to participant answers in the screening tool, while clinical and cancer characteristics were obtained from medical records.

The mean pain score was 1.92±1.1, while the mean anxiety and depression scores were 2.03±1.1 and 1.86±1.0, respectively. Majority (64.5 percent) of the participants had early stage malignancies.

Hierarchical multiple regression analysis was performed to identify factors predictive of pain distress. The first model, including only demographic variables, explained 14 percent of the variance in pain scores. Among these variables, household income, education level and the language used in the screening tool emerged as significant correlates.

The second model found that the stage of the disease was also a significant predictor of pain distress (p=0.009) but accounted for only a small change in the variance in pain scores. Further incorporation of feelings of anxiety (p=0.012) and depression (p<0.001) likewise led to a significant improvement in the predictive capacity of the model (p<0.001).

Overall, the model was able to explain 31 percent of the variability in self-reported pain scores. This suggests that oncology practitioners should look out for specific psychological and sociodemographic markers that may “identify patients at risk for experiencing pain as distressing prior to starting cancer treatment,” the researchers said.