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Cancer Pain: An Age-Based Analysis

Authors

  • Carmen R. Green MD,

    Corresponding author
    1. Departments of Anesthesiology
    2. Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, Michigan
    3. Department of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, Michigan, USA
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  • Tamera Hart-Johnson MS

    1. Departments of Anesthesiology
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Carmen R. Green, MD, Professor of Anesthesiology, Obstetrics and Gynecology, and Health Management and Policy, University of Michigan, Department of Anesthesiology, 1H247 University Hospital, 1500 East Medical Center Drive SPC 5048, Ann Arbor, MI 48109-5048, USA.
Tel: 734-936-4240; Fax: 734-936-9091; E-mail: carmeng@med.umich.edu.

Abstract

Objective.  Although cancer pain (consistent and breakthrough pain [BTP; pain flares interrupting well-controlled baseline pain]) is common among cancer patients, its characteristics, etiology, and impact on health-related quality of life (HRQOL) across the lifespan are poorly understood.

Design.  This longitudinal study examines age-based differences and pain-related interference in young and old patients with cancer-related pain over 6 months. Patients in the community with stage III or IV breast, prostate, colorectal, or lung cancer, or stage II–IV multiple myeloma with BTP completed surveys (upon initial assessment, 3 and 6 months) assessing consistent pain, BTP, depressed affect, active coping ability, and HRQOL using previously validated measures.

Results.  Respondents (N = 96) were 70% white and 66% female, with a mean age of 57 ± 10 years. There were no significant differences in pain severity based upon age. However, the younger group experienced more pain flares with greater frequency (P = 0.05). The oldest group had better emotional functioning at baseline but worse physical functioning at 6 months. Younger groups also had worse cognitive functioning at 6 months (P = 0.03). Pain interference was independent of age.

Conclusions.  These data provide evidence for the significant toll of cancer pain on overall health and well-being of young and old adults alike but demonstrate an increased toll for younger adults (especially financially). Beyond race and gender disparities, further health care disparities in the cancer and cancer pain were identified by age, illustrating the need for additional research across the lifespan in diverse cancer survivors.

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