Pain, cancer-related distress, and physical and functional well-being among men with advanced prostate cancer

Emily A Walsh; Patricia B Pedreira; Patricia I Moreno; Paula J Popok; Rina S Fox; Betina Yanez; Michael H Antoni; Frank J Penedo

doi:10.1007/s00520-022-07453-0

Pain, cancer-related distress, and physical and functional well-being among men with advanced prostate cancer

Support Care Cancer. 2022 Dec 14;31(1):28. doi: 10.1007/s00520-022-07453-0.

Authors

Emily A Walsh¹, Patricia B Pedreira¹, Patricia I Moreno^{2

3}, Paula J Popok¹, Rina S Fox⁴, Betina Yanez⁵, Michael H Antoni^{1

3}, Frank J Penedo^{6

7}

Affiliations

¹ Department of Psychology, University of Miami, Coral Gables, FL, USA.
² Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, USA.
³ Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA.
⁴ College of Nursing, University of Arizona, Tucson, AZ, USA.
⁵ Department of Medical Social Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
⁶ Department of Psychology, University of Miami, Coral Gables, FL, USA. frank.penedo@miami.edu.
⁷ Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL, USA. frank.penedo@miami.edu.

Abstract

Purpose: Men with advanced prostate cancer (APC) experience high levels of pain, which contribute to poor psychosocial and functional outcomes. Cancer-related distress explains the relationship between pain severity and interference, yet specificity of distress characteristics (e.g., hyperarousal, intrusive, or avoidant symptoms) in explaining associations between pain experiences and well-being has not been explored within APC. This study examined men with APC entering a clinical trial and tested associations of baseline pain, cancer-related distress, and physical and functional well-being.

Methods: One hundred ninety men with APC enrolled in a randomized-controlled trial and were assessed prior to randomization. The McGill Pain Questionnaire assessed pain severity, and the Functional Assessment of Cancer Therapy-General captures physical and functional well-being. The Impact of Events Scale-Revised measured cancer-specific distress symptoms, including hyperarousal, avoidance, and intrusion symptoms. Controlling for age, cancer stage at diagnosis, income, education, and race/ethnicity, mediation models (SPSS PROCESS, model 4) tested whether cancer-specific distress accounted for the associations between pain severity and physical and functional well-being.

Results: Men were on average 68 years of age, White non-Hispanic, with stage IV cancer. Pain severity was related to poorer physical (p < .001) and functional well-being (p < .001). Associations between pain severity and physical and functional well-being were partially mediated by greater intrusive and hyperarousal symptoms but not avoidant symptoms.

Conclusion: For men with APC, intrusive and hyperarousal symptoms may partially explain the relationship between pain severity and decrements in physical and functional well-being. APC pain management should attend to such distress symptoms, which may contribute to interference if left unaddressed.

Trial registration: ClinicalTrials.gov Identifier: NCT03149185.

Keywords: Cancer-related distress; Cognitive behavioral stress management; Functional well-being; Physical well-being; Prostate cancer.

Publication types

Randomized Controlled Trial

MeSH terms

Cancer Pain* / etiology
Humans
Male
Neoplasm Staging
Pain Measurement
Prostatic Neoplasms* / psychology

Associated data

ClinicalTrials.gov/NCT03149185

Abstract

Publication types

MeSH terms

Associated data

Grants and funding