Pretreatment pain intensity is an independent survival predictor for patients with head and neck cancer (HNC), according to new research published in the Journal of Pain (October 2014, Vol. 15:10, pp. 1015-1022).
Researchers at MD Anderson Cancer Center in Houston assessed the extent to which pain severity influences survival in 2,340 newly diagnosed HNC patients. At first presentation, patients rated their pain using a scale in which 0 meant no pain and 10 indicated "pain as bad as you can imagine." Survival time was calculated from diagnosis to death or last follow-up.
Pain often is the first sign of head and neck cancer, as a result of destructive lesions and direct tissue and bone involvement. Acute pain from therapy is very common from surgery, chemotherapy, and radiation.
Results of the study showed that severe pain was reported by 19% of the patients and was most prevalent in patients with oral cancer (20%). Pain intensity varied based on tumor stage, fatigue, smoking status, and comorbid lung disease.
Some 828 patients died. Among those with oral cancer, overall five-year survival was 31% for patients who reported severe pain and 52% for those without severe pain. The survival differentiation was similar in patients with pharyngeal cancer.
Pretreatment pain severity in HNC patients is an independent predictor of overall five-year survival, the study authors concluded. They noted that patients who present with severe pain at diagnosis should be closely monitored and promptly treated for pain symptoms.
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