A pain management program for chronic cancer-treatment-related pain: a preliminary study.
A large proportion of patients may develop chronic pain following cancer treatments such as surgery, radiotherapy, or chemotherapy. These patients can experience significant levels of physical and psychological morbidity. Our aim was to investigate a cognitive-behavioral pain management program (PMP) for cancer patients with chronic treatment-related pain. Thirteen patients (1 man, 12 women; mean age 52 yrs) completed the study, 9 of whom had a history of breast cancer and had received extensive medical treatment, including surgery. A combination of physical and psychological techniques were adapted from previous work in chronic benign pain and implemented by two therapists. Interventions included education, relaxation, exercise training, and goal setting. A variety of outcomes were examined to assess general fitness, psychological distress, coping success, activities of daily living, and pain report. The median number of interventions by each therapist was 10 (4 to 15). Postintervention, there was a significant trend toward improvement in many variables, including anxiety and depression (P < .01), fitness (walking: P < .05), and coping with pain (P < .01). This was a feasibility study and has several limitations. It appears, however, that all patients had a positive outcome. Further research is now required to assess the effectiveness of this approach.


CONCLUSIONS
Results of this preliminary study are clinically relevant, as they suggest that a pain management program that uses cognitive-behavioral principles is worthy of further investigation for patients with chronic cancer-treatment-related pain.
Robb
Karen A
KA
Academic Department of Physiotherapy, School of Biomedical Sciences, King's College London, London, UK. karen.robb@kcl.ac.uk
Williams
John E
JE
Duvivier
Valerie
V
Newham
Di J
DJ
D000328:Adult; D002908:Chronic Disease; D015928:Cognitive Behavioral Therapy; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications* / Q000532:radiotherapy / Q000601:surgery; D010146:Pain / Q000209:etiology / Q000523:psychology; D059408:Pain Management; D010147:Pain Measurement; D026741:Physical Therapy Modalities; D015397:Program Evaluation; D011878:Radiotherapy / Q000009:adverse effects; D013514:Surgical Procedures, Operative / Q000009:adverse effects; D016896:Treatment Outcome