Strategies of Coping with Pain: Differences Associated with the Histological Type of Lung Cancer

Behavioral cognitive therapy is recommended for lung cancer-related pain. The aim of the study was to analyze the strategies of coping with pain in relation to the histological type of lung cancer. The study included 257 lung cancer patients, divided into small cell lung carcinoma (SCLC) group (n = 72) and non-small cell lung carcinoma (NSCLC) group (n = 185). Pain was evaluated on a visual analog scale (VAS), while pain-coping strategies with the Coping Strategies Questionnaire. The two groups differed concerning the perception of pain - VAS score of 4.8 ± 2.0 in SCLC vs. 4.2 ± 2.0 in NSCLC group (p = 0.003). SCLC patients were less likely to use the active coping strategies, such as increasing behavioral activity (13.6 ± 7.0 vs. 16.9 ± 6.9; p = 0.001), and pain control (2.5 ± 1.2 vs. 3.4 ± 1.2; p < 0.001), and were lees able to decrease pain (2.4 ± 1.3 vs. 3.5 ± 1.3; p < 0.001). The most common pain-coping strategy in SCLC was praying or hoping, while it consisted of increased behavioral activity and active coping in NSCLC. Correlation analysis for coping strategies and pain intensity showed a negative influence (increased pain) for the following domains: diverting attention (r = 0.264, β = 0.93); reinterpreting of pain sensations (r = 0.327, β = 0.97); catastrophizing (r = 0.383, β = 1.11); ignoring pain sensations (r = 0.306, β = 0.93), praying or hoping (r = 0.220, β = 0.76), coping self-statements (r = 0.358, β = 1.10), and increased behavioral activity (r = 0.159, β = 0.57). For pain control (r = -0.423, β = -0.27) and the ability to decrease pain (r = -0.359, β = -0.27), a positive influence (decreased pain) was found. The significant independent determinants of pain perception in the NSCLC group were: pain control strategy (β = -0.39) and coping self-statement (β = 0.72). We conclude that in NSCLC patients both pain control and the ability to decrease pain are the strategies which decrease the intensity of perceived pain. In contrast, SCLC patients have no clear strategy for pain-coping.