A report by researchers from Mount Sinai, Memorial Sloan-Kettering Cancer Center, University of Virginia, and the American Cancer Society finds that about one-third of cancer survivors (34.6%) reported having chronic pain. That is almost double the rate in the general US population. The report was published June 20, 2019 as a research letter in JAMA Oncology.
Chronic pain is one of the most common long-term side-effects of cancer treatment and has been linked with lower quality of life, less likelihood of following treatment schedules, and higher health care costs. This study defined two types of pain: chronic pain and high impact chronic pain. Chronic pain meant having pain on most days or every day in the past 6 months. High impact chronic pain was pain severe enough to limit daily activities.
The researchers used data from the National Health Interview Survey (2016-2017) and identified 4,526 survivors. One-third of them (34.6%) reported having chronic pain. If that rate were applied to the country as a whole, it would represent about 5.4 million cancer survivors. About one in 6 survivors (16%) reported high impact chronic pain.
Rates of both types of pain were highest among those who had less than a high school education, had low income, were 18-to 64-year-olds on public insurance, or who did not have a paid job. There was no link between the time since diagnosis and either type of pain, but survivors who had bone, kidney, throat, and uterine cancers had the highest reports of pain.
These high rates suggest that treatment centers could better manage cancer-related side effects said Xuesong Han, PhD, American Cancer Society Investigator and co-author of the report. It also suggests that doctors should talk to patients about side effects even years after their treatment ends.
Another recent study also found evidence that some patients are not getting information that could help them cope with significant side-effects. Researchers found that 30% to 50% of patients with breast or colorectal cancer who were treated in community cancer centers said they either did not have conversations with their doctors or they did not get advice about pain, fatigue, or emotional distress resulting from cancer or cancer treatment.
The article by researchers from the American Cancer Society, National Cancer Institute, Emory University, Cancer Support community, and American College of Surgeons was published May 17, 2019 in Journal of Clinical Oncology.
The researchers analyzed 2,487 surveys from 17 cancer centers across the US that asked patients with breast or colorectal cancer about side effects and the type of care they received. They found that 61% of those surveyed experienced pain, but only 58% received the help they wanted for it. For fatigue, 74% reported it but only 40% received the guidance they felt they needed to deal with it. And when it came to distress, 46% of those surveyed felt it and 45% gained helpful knowledge on what to do about it.
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Prevalence of Chronic Pain and High-Impact Chronic Pain in Cancer Survivors in the United States. Published June 20, 2019 in JAMA Oncology. First author Changchuan Jiang, MD, MPH, Mount Sinai St Luke’s Hospital and Mount Sinai West Hospital, New York.
Perceptions of Patients With Breast and Colon Cancer of the Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology. Published May 17, 2019 in Journal of Clinical Oncology. First author Tenbroeck G. Smith, MA, American Cancer Society, Atlanta, Ga.
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