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Supportive Care in Cancer
Published in: Supportive Care in Cancer 7/2010

01-07-2010 | Original Article

Anxiety, depression, and pain: differences by primary cancer

Authors: Dena J. Fischer, Dana Villines, Young Ok Kim, Joel B. Epstein, Diana J. Wilkie

Published in: Supportive Care in Cancer | Issue 7/2010

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Abstract

Goals of work

Disease-related cancer pain is a multidimensional phenomenon. Psychological factors that may alter pain perception in cancer patients have not been well studied. The study purpose was to explore differences in pain, anxiety, and depression by type of primary cancer.

Patients and methods

In a cross-sectional study of consecutive patients (80% male, mean age 60.5 ± 11.5 years) undergoing radiation treatment for head/neck (HNC, n = 93), lung (LC, n = 146), or prostate (PC, n = 63) cancers, patients reported pain quality, pattern, and intensity with the McGill Pain Questionnaire. They also completed the State Trait Anxiety Inventory, Center for Epidemiologic Studies Depression Scale, and Coping Strategies Questionnaire. Comparative statistics, correlation coefficients, and multivariate regression analysis were performed.

Main results

Worst pain intensity was significantly greater in LC subjects compared to HNC (p < 0.05) and PC (p < 0.001). Pain quality ratings were significantly greater for individuals with LC compared to PC (p < 0.05), and the regression analyses indicated that pain quality ratings were partially predicted by having LC. Depression levels approached clinical significance and were greatest for individuals with LC. Catastrophizing was correlated with high levels of depression (p < 0.01) and anxiety (p < 0.01).

Conclusions

Individuals with cancer undergoing radiation treatment experienced clinically significant levels of unrelieved cancer pain despite standard pain management. Pain intensity and quality ratings were greatest for LC individuals and may contribute to symptoms of depression. Catastrophizing may contribute to psychological factors which may impact the pain experience. Tailored treatments that meet cancer patients’ psychosocial and medical needs may result in improved pain management and functional ability.
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Metadata
Title
Anxiety, depression, and pain: differences by primary cancer
Authors
Dena J. Fischer
Dana Villines
Young Ok Kim
Joel B. Epstein
Diana J. Wilkie
Publication date
01-07-2010
Publisher
Springer-Verlag
Published in
Supportive Care in Cancer / Issue 7/2010
Print ISSN: 0941-4355
Electronic ISSN: 1433-7339
DOI
https://doi.org/10.1007/s00520-009-0712-5

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