Age-Related Patterns in Adaptation to Cancer Pain: A Mixed-Method Study

Authors

  • Lucia Gagliese PhD,

    Corresponding author
    1. School of Kinesiology and Health Science, York University, Toronto;
    2. Behavioural Sciences and Health Research Division, Toronto General Research Institute;
    3. Department of Anesthesia and Pain Management;
    4. Department of Psychosocial Oncology and Palliative Care;
    5. Psychosocial Oncology and Palliative Care Research Division, Ontario Cancer Institute;
    6. Faculty of Medicine and
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  • Melissa Jovellanos MSc,

    1. School of Kinesiology and Health Science, York University, Toronto;
    2. Behavioural Sciences and Health Research Division, Toronto General Research Institute;
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  • Camilla Zimmermann MD,

    1. Department of Psychosocial Oncology and Palliative Care;
    2. Psychosocial Oncology and Palliative Care Research Division, Ontario Cancer Institute;
    3. Faculty of Medicine and
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  • Cindy Shobbrook RN,

    1. Lawrence Bloomberg Faculty of Nursing, University of Toronto, Toronto;
    2. Cancer Pain Program,
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  • David Warr MD,

    1. Faculty of Medicine and
    2. Cancer Pain Program,
    3. Department of Medical Oncology and Hematology, University Health Network, Toronto, Canada
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  • Gary Rodin MD

    1. Behavioural Sciences and Health Research Division, Toronto General Research Institute;
    2. Department of Psychosocial Oncology and Palliative Care;
    3. Psychosocial Oncology and Palliative Care Research Division, Ontario Cancer Institute;
    4. Faculty of Medicine and
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  • Original Research Article

Lucia Gagliese, PhD, Behavioural Sciences and Health Research Division, University Health Network, 9EN-236A, 200 Elizabeth Street, Toronto, Ontario M5G 2C4, Canada. Tel: 416-340-4296; Fax: 416-340-4739; E-mail: lucia.gagliese@uhn.on.ca.

ABSTRACT

Objective.  Although older people make up the majority of cancer patients, little is known about aging and cancer pain. The objective of this study was to explore age-related patterns in adaptation to chronic cancer-related pain in younger and older patients.

Design.  A mixed-method study combining quantitative measures with individual semi-structured interviews. Quantitative measures included the Brief Pain Inventory, Pain Management Index, Charlson Comorbidity Index, and Karnofsky Performance Status.

Setting.  Two outpatient clinics (Palliative Care and Cancer Pain service) in an academic cancer hospital.

Participants.  Fifteen younger (average age: 48.9 ± 4.9 years old) and 17 older (average age: 72.4 ± 9.2 years old) people with cancer-related pain.

Results.  Two age-related adaptation outcomes emerged from the interviews: “Waiting to live” and “Living despite pain.” Younger patients were more likely than older patients to be “Waiting to live.” They felt that complete pain relief was necessary before their lives could move forward and reported feeling out of control, angry, and unable to accept their pain. Marital strain was common. “Living despite pain” was more frequent among older than younger patients. These patients accepted pain as an inevitable part of cancer, pursued life goals, and modified activities to maximize engagement. Marital growth was common.

Conclusion.  Older and younger cancer patients described different adaptations to cancer pain despite reporting comparable pain intensity and interference. Older patients adapted by employing accommodative strategies. Younger patients were less likely to use these strategies and struggled with accepting the losses associated with cancer pain. These findings may guide future research into age-related patterns in cancer pain and the development of psychosocial interventions tailored to patients' life stage challenges.

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