BACKGROUND: Although survivors of childhood cancer are at risk of chronic pain, the impact of pain on daily functioning is not well understood. METHODS: A total of 2836 survivors (mean age, 32.2 years [SD, 8.5 years]; mean time since diagnosis, 23.7 years [SD, 8.2 years]) and 343 noncancer community controls (mean age, 35.5 years [SD, 10.2 years]) underwent comprehensive medical, neurocognitive, and physical performance assessments, and completed measures of pain, health-related quality of life (HRQOL), and social functioning. Multinomial logistic regression models, using odds ratios and 95% confidence intervals (95% CIs), examined associations between diagnosis, treatment exposures, chronic health conditions, and pain. Relative risks (RRs) between pain and neurocognition, physical performance, social functioning, and HRQOL were examined using modified Poisson regression. RESULTS: Approximately 18% of survivors (95% CI, 16.1%-18.9%) versus 8% of controls (95% CI, 5.0%-10.9%) reported moderate to very severe pain with moderate to extreme daily interference (P < .001). Severe and life-threatening chronic health conditions were associated with an increased likelihood of pain with interference (odds ratio, 2.03; 95% CI, 1.62-2.54). Pain with daily interference was found to be associated with an increased risk of impaired neurocognition (attention: RR, 1.88 [95% CI, 1.46-2.41]; and memory: RR, 1.65 [95% CI, 1.25-2.17]), physical functioning (aerobic capacity: RR, 2.29 [95% CI, 1.84-2.84]; and mobility: RR, 1.71 [95% CI, 1.42-2.06]), social functioning (inability to hold a job and/or attend school: RR, 4.46 [95% CI, 3.45-5.76]; and assistance with routine and/or personal care needs: RR, 5.64 [95% CI, 3.92-8.10]), and HRQOL (physical: RR, 6.34 [95% CI, 5.04-7.98]; and emotional: RR, 2.83 [95% CI, 2.28-3.50]). CONCLUSIONS: Survivors of childhood cancer are at risk of pain and associated functional impairments. Survivors should be screened routinely for pain and interventions targeting pain interference are needed.
BACKGROUND: Although survivors of childhood cancer are at risk of chronic pain, the impact of pain on daily functioning is not well understood. METHODS: A total of 2836 survivors (mean age, 32.2 years [SD, 8.5 years]; mean time since diagnosis, 23.7 years [SD, 8.2 years]) and 343 noncancer community controls (mean age, 35.5 years [SD, 10.2 years]) underwent comprehensive medical, neurocognitive, and physical performance assessments, and completed measures of pain, health-related quality of life (HRQOL), and social functioning. Multinomial logistic regression models, using odds ratios and 95% confidence intervals (95% CIs), examined associations between diagnosis, treatment exposures, chronic health conditions, and pain. Relative risks (RRs) between pain and neurocognition, physical performance, social functioning, and HRQOL were examined using modified Poisson regression. RESULTS: Approximately 18% of survivors (95% CI, 16.1%-18.9%) versus 8% of controls (95% CI, 5.0%-10.9%) reported moderate to very severe pain with moderate to extreme daily interference (P < .001). Severe and life-threatening chronic health conditions were associated with an increased likelihood of pain with interference (odds ratio, 2.03; 95% CI, 1.62-2.54). Pain with daily interference was found to be associated with an increased risk of impaired neurocognition (attention: RR, 1.88 [95% CI, 1.46-2.41]; and memory: RR, 1.65 [95% CI, 1.25-2.17]), physical functioning (aerobic capacity: RR, 2.29 [95% CI, 1.84-2.84]; and mobility: RR, 1.71 [95% CI, 1.42-2.06]), social functioning (inability to hold a job and/or attend school: RR, 4.46 [95% CI, 3.45-5.76]; and assistance with routine and/or personal care needs: RR, 5.64 [95% CI, 3.92-8.10]), and HRQOL (physical: RR, 6.34 [95% CI, 5.04-7.98]; and emotional: RR, 2.83 [95% CI, 2.28-3.50]). CONCLUSIONS: Survivors of childhood cancer are at risk of pain and associated functional impairments. Survivors should be screened routinely for pain and interventions targeting pain interference are needed.
Authors: Melissa M Hudson; Kirsten K Ness; Vikki G Nolan; Gregory T Armstrong; Daniel M Green; E Brannon Morris; Sheri L Spunt; Monika L Metzger; Kevin R Krull; James L Klosky; Deo Kumar Srivastava; Leslie L Robison Journal: Pediatr Blood Cancer Date: 2010-12-15 Impact factor: 3.167
Authors: Qian Lu; Kevin R Krull; Wendy Leisenring; Jason E Owen; Toana Kawashima; Jennie C I Tsao; Bradley Zebrack; Ann Mertens; Gregory T Armstrong; Marilyn Stovall; Leslie L Robison; Lonnie K Zeltzer Journal: Pain Date: 2011-09-09 Impact factor: 6.961
Authors: Melissa M Hudson; Matthew J Ehrhardt; Nickhill Bhakta; Malek Baassiri; Hesham Eissa; Wassim Chemaitilly; Daniel M Green; Daniel A Mulrooney; Gregory T Armstrong; Tara M Brinkman; James L Klosky; Kevin R Krull; Noah D Sabin; Carmen L Wilson; I-Chan Huang; Johnnie K Bass; Karen Hale; Sue Kaste; Raja B Khan; Deo Kumar Srivastava; Yutaka Yasui; Vijaya M Joshi; Saumini Srinivasan; Dennis Stokes; Mary Ellen Hoehn; Matthew Wilson; Kirsten K Ness; Leslie L Robison Journal: Cancer Epidemiol Biomarkers Prev Date: 2016-12-29 Impact factor: 4.254
Authors: Melissa M Hudson; Kirsten K Ness; James G Gurney; Daniel A Mulrooney; Wassim Chemaitilly; Kevin R Krull; Daniel M Green; Gregory T Armstrong; Kerri A Nottage; Kendra E Jones; Charles A Sklar; Deo Kumar Srivastava; Leslie L Robison Journal: JAMA Date: 2013-06-12 Impact factor: 56.272
Authors: Marita Partanen; Nicole M Alberts; Heather M Conklin; Kevin R Krull; Ching-Hon Pui; Doralina A Anghelescu; Lisa M Jacola Journal: Pain Date: 2021-09-25 Impact factor: 7.926
Authors: Nina S Kadan-Lottick; Daniel J Zheng; Mingjuan Wang; Michael W Bishop; Deo Kumar Srivastava; Wilhelmenia L Ross; Rozalyn L Rodwin; Kirsten K Ness; Todd M Gibson; Sheri L Spunt; Mehmet Fatih Okcu; Wendy M Leisenring; Leslie L Robison; Gregory T Armstrong; Kevin R Krull Journal: J Cancer Surviv Date: 2022-01-21 Impact factor: 4.062