Department of Oral Medicine & Diagnostic Sciences, College of Dentistry, University of Illinois at Chicago, Chicago, IL 60612-7213, USA.
Support Care Cancer. 2010 Jul;18(7):801-10. doi: 10.1007/s00520-009-0712-5. Epub 2009 Aug 17.
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.
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.
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).
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.
疾病相关的癌痛是一种多维现象。癌症患者中可能改变疼痛感知的心理因素尚未得到充分研究。本研究的目的是探讨不同原发癌类型之间疼痛、焦虑和抑郁的差异。
在一项连续患者（80%为男性，平均年龄 60.5±11.5 岁）的横断面研究中，这些患者正在接受头颈部（HNC，n=93）、肺癌（LC，n=146）或前列腺癌（PC，n=63）的放射治疗，患者使用 McGill 疼痛问卷报告疼痛性质、模式和强度。他们还完成了状态特质焦虑量表、流行病学研究抑郁量表和应对策略问卷。进行了比较统计学、相关系数和多元回归分析。
LC 患者的最差疼痛强度明显大于 HNC（p<0.05）和 PC（p<0.001）。LC 患者的疼痛质量评分明显大于 PC 患者（p<0.05），回归分析表明疼痛质量评分部分由 LC 决定。抑郁水平接近临床意义，LC 患者的抑郁程度最高。灾难化与高水平的抑郁（p<0.01）和焦虑（p<0.01）相关。
尽管进行了标准的疼痛管理，正在接受放射治疗的癌症患者仍经历着明显的、无法缓解的癌症疼痛。LC 患者的疼痛强度和质量评分最高，这可能导致抑郁症状。灾难化可能会导致影响疼痛体验的心理因素。针对癌症患者的社会心理和医疗需求的个体化治疗可能会改善疼痛管理和功能能力。
