According to a population study published recently in JAMA Oncology, cancer survivors are more likely to suffer from chronic pain and high-impact chronic pain than the general population. The study evaluated long-term outcomes among 4526 adult cancer survivors included in the US National Health Interview Survey. Chronic pain occurred in 1648 (34.6%) and high-impact chronic pain (HICP) occurred in 768 (16.1%) survivors. This represents approximately twice the rate of chronic pain and HICP compared with the general US population. Some demographic factors such as gender, marital status, age, and region did not impact rates of pain. However, socioeconomic factors, such as lower education, low income, and public insurance, were associated with higher rates of chronic pain, suggesting that some disparities may exist in the quality of care received. Certain cancers were associated with a heavier ongoing pain burden. Survivors of bone, kidney, throat-pharynx, and uterine cancers were more likely to experience chronic pain and HICP.
High Altitude: This study provides important insight into chronic pain among cancer survivors. While current clinical research focuses on disease outcomes, adverse events, and some general quality of life parameters, low-grade but long-term effects like chronic pain may not be thoroughly considered. The JAMA Oncology article raises the issue of chronic pain as a possible challenge among oncology survivors, but the database lacks many important details that would be necessary to formulate an effective plan to improve the situation. For that, additional research will be needed, and posttreatment pain analyses might be a beneficial addition to future clinical trials, to identify therapies with improved “posttreatment tolerability,” especially for the bone, kidney, throat-pharynx, and uterine cancer settings. Of note, the higher rates of chronic pain among patients on the basis of socioeconomic background may represent a disparity in care. Further research is needed to determine if socioeconomic factors are driving the selection of treatments that might have a higher rate of long-term adverse consequences such as chronic pain, or undermining the effective monitoring and management of posttreatment adverse events.
Ground Level: Appropriate pain management is a key component of care for patients with cancer. This study identifies a relatively high burden of chronic pain following cancer treatment, particularly on the basis of socioeconomic background. Maintaining patients’ quality of life has emerged as a major goal for cancer care, both during and after treatment. Pain, a common side effect of cancer treatment, has a significant negative impact on patient functioning and quality of life. This study underscores the importance of proactive symptom monitoring and ongoing pain management for cancer survivors during long-term follow-up, especially those with limited support networks or a history of cancers associated with increased risk of chronic pain (eg, bone, kidney, throat-pharynx, and uterine cancers).