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The burden of chronic pain after major head and neck tumor therapy
Abdullah Sulieman Terkawi1,2,3, Siny Tsang4, Anwar S Alshehri5
1Department of Anesthesiology, University of Virginia, Charlottesville, VA, USA.
Introduction:
Little is known about the burden of chronic pain after major head and neck tumors' therapy. In this study, we aimed to estimate the prevalence of chronic pain, explore the factors associated with the presence of chronic pain, and assess the consequences of chronic pain on the patients' quality of life.
Methodology:
This was a cross-sectional survey among patients who had completed their therapy (e.g., surgery, radiotherapy, and chemotherapy) for major head and neck (larynx, nasopharynx, oropharynx, hypopharynx, oral cavity, tongue, and sinuses) tumors after at least 3 months. We collected relevant demographic and clinical data and administered the Brief Pain Inventory-Short Form, Neuropathic Pain Questionnaire-Short Form, and Pain Catastrophizing Scale questionnaires. Possible risk factors were explored using a classification tree model.
Results:
A total of 102 patients (59 men, 42 women) were enrolled in this study between 3 and 72 months after tumor treatment. 30% of the patients reported having chronic pain after their major head and neck tumors' therapy. The average pain score in the last 24-hr was 3.4 (standard deviation = 2.7). The prevalence of patients with chronic pain was higher (42%) among those who had surgery. Factors associated with chronic pain were female sex, older age, surgery, advanced cancer stage, and radiotherapy. Patients who reported having chronic pain also reported having a lower quality of life manifested by impairments in general activity, mood, walking ability, normal work, and sleeping. Patients who reported having chronic pain had higher Pain Catastrophizing Scale scores.
Conclusion:
Our study highlighted the high burden of chronic pain after therapy for major head and neck tumors. We identified demographic and clinical factors that are associated with the presence of chronic pain. Further studies are required to better understand the risk factors to implement strategies to prevent, alleviate, and treat chronic pain associated with major head and neck tumor therapies.
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