Anxiety, depression, pain, and social support in a large representative cancer population.

Authors

null

Sarah Kathryn Galloway

Levine Cancer Institute, Charlotte, NC

Sarah Kathryn Galloway, Patrick Meadors, Danielle Boselli, Declan Walsh

Organizations

Levine Cancer Institute, Charlotte, NC, Levine Cancer Institute, Atrium Health, Charlotte, NC, Harry R. Horvitz Center for Palliative Medicine, Cleveland, OH

Research Funding

No funding received
None
Background: Pain is one of the most common cancer symptoms. Individuals in pain often experience psychological distress in the form of anxiety and depression. Social support is an important resource utilized by patients to cope with cancer.

Aims: (1) Identify clinicodemographic factors influencing cancer pain; (2) examine social support as a moderator of the relation between anxiety, depression and cancer pain.

Methods: Participants included stage I-IV cancer patients (N = 11,815) who completed a routine tablet-based psychosocial distress screening at a large academic hybrid, multi-site, community-based cancer institute (Jan 2017- Jan 2019). Participants were matched to the Cancer Registry (N = 7,333); clinicodemographic factors were incorporated into lasso regression models. Models identified pain predictors from self-reported anxiety, depression and social support. Analyses examined if the effect of anxiety and depression on pain differed by levels of social support.

Results: Median age was 59 (RNG, 18-101), 61% female and 77% white. Tumor site (GI, Gyn, head/neck), advanced disease, black race, and lower income were independently associated with severe pain. Anxiety (β = 0.48, p < .001) and depression (β = 0.69, p < 0.001) were related to pain intensity after accounting for clinicodemographic factors. The effect of depression on pain differed by level of social support (p = 0.009). The effect of anxiety on pain differed in patients reporting transportation issues (p = 0.035).

Conclusions: This is the largest study to date examining cancer pain intensity, psychological factors of anxiety and depression, and social support. Our data suggests that patient characteristics of race, income, tumor site, and disease staging independently predict pain intensity. Anxiety and depression are significant factors of pain intensity; these associations remain after accounting for patient characteristics. Social support buffers the negative impact of anxiety/depression on pain. Clinicians who treat cancer pain should be attuned to modifiable psychological factors which can greatly influence a patient’s pain experience. Findings emphasize the need for interdisciplinary multimodal approaches for cancer pain.

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Abstract Details

Meeting

2019 Supportive Care in Oncology Symposium

Session Type

General Session

Session Title

Psychosocial Issues: New Challenges and Solutions

Track

Education Track

Sub Track

Mental Health and Psychological Well-being

Citation

J Clin Oncol 37, 2019 (suppl 31; abstr 76)

DOI

10.1200/JCO.2019.37.31_suppl.76

Abstract #

76

Abstract Disclosures

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