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The Effect of Pain Catastrophizing on Acupuncture Treatment for Chronic Pain in Cancer Survivors
Hyowoun Jyung1, Lingyun Sun2, Qing Li1
1Department of Medicine (H.J., L.S., Q.L., S.C., X.L., K.T.L., J.J.M.), Memorial Sloan Kettering Cancer Center, Integrative Medicine Service, New York, New York, USA.
Context:
Pain catastrophizing (PC) predicts worse pain outcomes in cancer survivors. However, little is known whether PC influences pain outcomes of nonpharmacological treatments such as acupuncture.
Objectives:
This study aimed to assess the impact of PC on acupuncture efficacy for chronic pain in cancer survivors.
Methods:
This secondary analysis of PEACE trial used two-sample t-test and Pearson's chi-squared test to analyze the pain outcomes of cancer survivors who received electroacupuncture (EA) or battlefield acupuncture (BFA). PC was measured using Pain Catastrophizing Scale (PCS). The Brief Pain Inventory (BPI) was used to measure pain severity and interference at the primary endpoint (week 12).
Results:
Among 266 participants, 41 (15.41%) had a high baseline PC. Among those receiving EA, high PC patients had greater reductions in pain severity (-3.9 vs. -2.1, P = 0.006) and pain interference (-3.8 vs. -2.6, P = 0.04) than low PC. PC was not associated with pain outcomes in BFA group (P > 0.05 for both severity and interference). Among patients with high PC, a greater proportion were responders in the EA group than those in BFA group (83.3% vs. 43.5%, P = 0.009). Among low PC patients, there was no significant difference in the proportion of responders between the EA and BFA groups (66.1% vs. 64.5%, P = 0.8).
Conclusion:
We found that cancer survivors with high baseline PC had greater pain reductions with EA than BFA and compared to low PC patients. These findings suggest that EA may serve as a targeted treatment option for vulnerable patients with high PC and further support precision pain management.
