Variations in pain prevalence, severity, and analgesic use by duration of survivorship: a cross-sectional study of 505 post-treatment head and neck cancer survivors

Abstract Background Studies suggest a high prevalence of pain in head and neck cancer (HNC) patients at diagnosis, during and after treatment; however, these studies had small sample sizes and did not comprehensively assess factors known to influence pain. We surveyed a large cohort of HNC survivors to determine variations in the prevalence of pain, its treatment and management by duration of survivorship, and assessed a comprehensive list of risk factors. Methods A cross sectional survey of post-treatment survivors of HNC during routine follow-up clinic visits. Results A total of 505 HNC survivors with a median follow up of 3 years from cancer diagnosis were included in the study. Overall, 45% (n = 224) reported pain and 14.5, 22 and 7% reported use of prescribed pain medication, over-the-counter pain medication and alternative pain therapies, respectively. Prevalence of severe pain was 7.3% and did not vary significantly by years of survivorship (< 1 year = 5.7%; 1 to < 3 years = 7.1%; 3 to < 8 years = 7.6%; 8 years or more =9.7%; P = 0.392). However, use of prescribed pain medication significantly varied by years of survivorship (< 1 year = 45.7%; 1 to < 3 years = 24.6%; 3 to < 8 years = 18.9; 8 years or more = 18.3%; p < 0.001). Of note, a significant proportion of survivors reported moderate to severe pain (moderate to severe = 55.7% versus none to mild = 44.3%) despite step 3 analgesic use (p < 0.001). Multivariable regression shows that recurrent disease (OR 6.77, 95% CI [1.44, 31.80]), history of chemotherapy (OR 6.00, 95% CI [2.10, 17.14]), and depression (Mild-moderate OR 5.30, 95% CI [2.20, 12.78]; Major OR 8.00, 95% CI [2.67, 23.96]) were significant risk factors for severe pain. Conclusions We identified a high prevalence of pain among HNC survivors and determined that analgesic use varied by the duration of survivorship. Therefore, routine surveillance for pain must be consistent throughout the course of survivorship.

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Patients' preferences concerning follow‐up after curative head and neck cancer treatment: A cross‐sectional pilot study

Head & Neck ◽

10.1002/hed.25686 ◽

2019 ◽

Vol 41 (7) ◽

pp. 2174-2181 ◽

Cited By ~ 4

Author(s):

Simon Andreas Mueller ◽

Julia Riggauer ◽

Olgun Elicin ◽

Daniela Blaser ◽

Sven Trelle ◽

...

Keyword(s):

Head And Neck Cancer ◽

Pilot Study ◽

Cancer Treatment ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional

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NSAID and other analgesic use by endurance runners during training, competition and recovery

South African Journal of Sports Medicine ◽

10.17159/2413-3108/2013/v25i4a340 ◽

2013 ◽

Vol 25 (4) ◽

pp. 101 ◽

Cited By ~ 1

Author(s):

J Joslin ◽

JB Lloyd ◽

T Kotlyar ◽

SM Wojcik

Keyword(s):

Cross Sectional Study ◽

Pain Medication ◽

Sectional Study ◽

Distance Runners ◽

Cross Sectional ◽

High Prevalence ◽

Analgesic Medication ◽

Potential Risks ◽

Ultra Endurance ◽

Analgesic Use

Background. An increasing popularity of ultra-endurance events coupled with excessive or inappropriate non-steroidal anti-inflammatory drug (NSAID) use during such events could pose considerable potential risks to runners’ health.Objective. To evaluate the incidence of NSAID and other analgesic use in distance runners during training, competition and recovery.Methods. We performed an observational cross-sectional study at the Desert Race Across the Sand race (Colorado to Utah, USA) in June 2011 and the Empire State Marathon half-marathon, and relay races in Syracuse, NY, October 2011. A total of 27 ultramarathon runners and 46 marathon, half-marathon and marathon relay runners participated in the study. Surveys were distributed to runners during race registration. Self-reported use of common analgesic medications during training, racing and recovery was assessed.Results. Among all runners at all stages, NSAIDs were the most commonly used analgesic medication. NSAID use by ultramarathon runners compared with all other runners was similar during training (59% and 63%, respectively; χ2=0.008; p=0.93) and recovery (59% and 61%, respectively; χ2=0.007; p=0.93). However, ultramarathon runners were more likely than all other runners to use NSAIDs during the race (70% and 26%, respectively; χ2=11.76; p=0.0006).Conclusion. Despite undesirable side-effects associated with the use of NSAIDs, there was a high prevalence of use in all runners, particularly during training and recovery. NSAID use during the race was significantly greater in ultramarathon runners. Medical staff at endurance events need to be aware of, and prepared for potential complications related to the high use of NSAIDs in runners. Future efforts should focus on teaching runners about the undesirable effects of medication and emphasising alternatives to pain medication.

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Multicenter Assessment of Antibiotic Prophylaxis Spectrum on Surgical Infections in Head and Neck Cancer Microvascular Reconstruction

Otolaryngology ◽

10.1177/0194599818756299 ◽

2018 ◽

Vol 159 (1) ◽

pp. 59-67 ◽

Cited By ~ 7

Author(s):

Michael P. Veve ◽

Joshua B. Greene ◽

Amy M. Williams ◽

Susan L. Davis ◽

Nina Lu ◽

...

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Antibiotic Prophylaxis ◽

Head And Neck ◽

Neck Cancer ◽

Tertiary Care ◽

Surgical Site Infections ◽

Cross Sectional Study ◽

Microvascular Reconstruction ◽

Cross Sectional

Objective To characterize and identify risk factors for 30-day surgical site infections (SSIs) in patients with head and neck cancer who underwent microvascular reconstruction. Study Design Cross-sectional study with nested case-control design. Setting Nine American tertiary care centers. Subjects and Methods Hospitalized patients were included if they underwent head and neck cancer microvascular reconstruction from January 2003 to March 2016. Cases were defined as patients who developed 30-day SSI; controls were patients without SSI at 30 days. Postoperative antibiotic prophylaxis (POABP) regimens were categorized by Gram-negative (GN) spectrum: no GN coverage, enteric GN coverage, and enteric with antipseudomonal GN coverage. All POABP regimens retained activity against anaerobes and Gram-positive bacteria. Thirty-day prevalence of and risk factors for SSI were evaluated. Results A total of 1307 patients were included. Thirty-day SSI occurred in 189 (15%) patients; median time to SSI was 11.5 days (interquartile range, 7-17). Organisms were isolated in 59% of SSI; methicillin-resistant Staphylococcus aureus (6%) and Pseudomonas aeruginosa (9%) were uncommon. A total of 1003 (77%) patients had POABP data: no GN (17%), enteric GN (52%), and antipseudomonal GN (31%). Variables independently associated with 30-day SSI were as follows: female sex (adjusted odds ratio [aOR], 1.6; 95% CI, 1.1-2.2), no GN POABP (aOR, 2.2; 95% CI, 1.5-3.3), and surgical duration ≥11.8 hours (aOR, 1.9; 95% CI, 1.3-2.7). Longer POABP durations (≥6 days) or antipseudomonal POABP had no association with SSI. Conclusions POABP without GN coverage was significantly associated with SSI and should be avoided. Antipseudomonal POABP or longer prophylaxis durations (≥6 days) were not protective against SSI. Antimicrobial stewardship interventions should be made to limit unnecessary antibiotic exposures, prevent the emergence of resistant organisms, and improve patient outcomes.

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Prevalence of pain in head and neck cancer out-patients

The Journal of Laryngology & Otology ◽

10.1017/s002221511000040x ◽

2010 ◽

Vol 124 (7) ◽

pp. 767-773 ◽

Cited By ~ 18

Author(s):

J E Williams ◽

J T C Yen ◽

G Parker ◽

S Chapman ◽

S Kandikattu ◽

...

Keyword(s):

Risk Factors ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Pain Treatment ◽

Breakthrough Pain ◽

Treatment Protocol ◽

Specific Risk ◽

Study Population ◽

Prevalence Of Pain

AbstractBackground:This study aimed to determine the prevalence of pain, and the adequacy of its treatment, amongst patients with head and neck cancer, and to determine whether specific groups could be identified as being at risk of pain.Methods:Consecutive patients attending head and neck oncology out-patient services were surveyed.Results:The prevalence of pain was 34 per cent, lower than that found in systematic reviews. No specific risk factors for pain were identified. Particular pain problems in this population comprised a high incidence of neuropathic pain, breakthrough pain and pain of non-malignant origin.Conclusion:The prevalence of unrelieved pain was high in this study population, although no specific risk factors were found. A further study is planned to determine the effect of using a routine screening tool and an immediate pain treatment protocol in this group of patients.

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Quality of Life of the Patient with Head and Neck Cancer Submitted to Radiotherapy and the Overload of Their Caregivers

International Archives of Otorhinolaryngology ◽

10.1055/s-0040-1718963 ◽

2021 ◽

Author(s):

Daniela Delalibera ◽

Alessandra Cristine Ribeiro Carvalho ◽

Bruna Luiza Thesolim ◽

Laura Ferreira de Rezende

Keyword(s):

Quality Of Life ◽

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Cross Sectional Study ◽

Cross Sectional ◽

Functional Changes ◽

Therapeutic Choice

Abstract Introduction Esthetic and functional changes are frequent in patients with head and neck cancer, and they can be caused by both tumor and treatment. Physical and functional impairment often requires the need of a caregiver, who may feel overwhelmed with the tasks of care. Objective This study aims to evaluate the quality of life of patients with head and neck cancer submitted to radiotherapy and the overload of their caregivers. Method This is a quantitative cross-sectional study with 42 patients with head and neck cancer and 17 caregivers evaluated during the radiotherapy treatment. Patients responded to the following questionnaires: Functional Assessment of Cancer Therapy for Head and Neck Cancer (FACT-H&N) and Shame and Stigma Scale (SSS), while the caregivers responded to the Zarit Burden Interview Scale (ZBI) and Palliative Performance Scale (PPS). Results Head and neck cancer patients showed a decline in the quality of life in all FACT-H&N domains, with the domain of additional concerns having the worst outcome. Among the feelings reported by patients, the most important was penitence. Less than half of the patients needed caregivers. It was observed that the greater the degree of commitment of the patient, the greater the degree of overload of the caregiver. Conclusion Therefore, the quality of life of the patient with head and neck cancer is an important aspect to be considered during the therapeutic choice and in the follow-up of the patient, since it has influenced both the patient and his caregiver.

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Appearance concerns and psychosocial adjustment following head and neck cancer: A cross-sectional study and nine-month follow-up

Psychology Health & Medicine ◽

10.1080/13548506.2013.855319 ◽

2013 ◽

Vol 19 (5) ◽

pp. 505-518 ◽

Cited By ~ 25

Author(s):

Sally-Ann Clarke ◽

Robert Newell ◽

Andrew Thompson ◽

Diana Harcourt ◽

Antje Lindenmeyer

Keyword(s):

Head And Neck Cancer ◽

Head And Neck ◽

Neck Cancer ◽

Psychosocial Adjustment ◽

Cross Sectional Study ◽

Sectional Study ◽

Cross Sectional

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NSAID and other analgesic use by endurance runners during training, competition and recovery

South African Journal of Sports Medicine ◽

10.17159/2078-516x/2013/v25i4a340 ◽

2013 ◽

Vol 25 (4) ◽

pp. 101 ◽

Cited By ~ 12

Author(s):

J Joslin ◽

JB Lloyd ◽

T Kotlyar ◽

SM Wojcik

Keyword(s):

Cross Sectional Study ◽

Pain Medication ◽

Sectional Study ◽

Distance Runners ◽

Cross Sectional ◽

High Prevalence ◽

Analgesic Medication ◽

Potential Risks ◽

Ultra Endurance ◽

Analgesic Use

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Psychological Resilience Provides No Independent Protection From Suicidal Risk

Crisis ◽

10.1027/0227-5910/a000364 ◽

2016 ◽

Vol 37 (2) ◽

pp. 130-139 ◽

Cited By ~ 9

Author(s):

Danica W. Y. Liu ◽

A. Kate Fairweather-Schmidt ◽

Richard Burns ◽

Rachel M. Roberts ◽

Kaarin J. Anstey

Keyword(s):

Risk Factors ◽

Well Being ◽

Current Status ◽

Psychological Resilience ◽

Cross Sectional ◽

Life Project ◽

Resilience Factors ◽

First Time

Abstract. Background: Little is known about the role of resilience in the likelihood of suicidal ideation (SI) over time. Aims: We examined the association between resilience and SI in a young-adult cohort over 4 years. Our objectives were to determine whether resilience was associated with SI at follow-up or, conversely, whether SI was associated with lowered resilience at follow-up. Method: Participants were selected from the Personality and Total Health (PATH) Through Life Project from Canberra and Queanbeyan, Australia, aged 28–32 years at the first time point and 32–36 at the second. Multinomial, linear, and binary regression analyses explored the association between resilience and SI over two time points. Models were adjusted for suicidality risk factors. Results: While unadjusted analyses identified associations between resilience and SI, these effects were fully explained by the inclusion of other suicidality risk factors. Conclusion: Despite strong cross-sectional associations, resilience and SI appear to be unrelated in a longitudinal context, once risk/resilience factors are controlled for. As independent indicators of psychological well-being, suicidality and resilience are essential if current status is to be captured. However, the addition of other factors (e.g., support, mastery) makes this association tenuous. Consequently, resilience per se may not be protective of SI.

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