Pain Prevalence in Head and Neck Cancer

Abstract

This study aimed to explicate the prevalence of pain in patients with head and neck cancer (HNC). Head and neck cancer is associated with intense, multi-modal treatment that may result in substantial morbidity. Research suggests a high prevalence of pain among patients with HNC, and the level of pain may predict patients' 5-year survival. Understanding the pain prevalence of patients with HNC during and after treatment may inform strategies for caring for patients with HNC. This study was a secondary analysis of a systematic review of symptom and function measures used by patients with HNC. A systematic search of CINAHL, PubMed, APA PsycInfo®, and Health and Psychosocial Instruments (HaPI) databases between January 2005 and April 2020 generated 529 titles. Articles that described symptoms and functional limitations in HNC and met quality criteria were retained and reviewed for reports of pain prevalence. The review was registered with the National Institute of Health Research (CRD42021242513) and conducted according to PRISMA guidelines. The literature review identified eight articles that contained 12 reports of pain prevalence in patients with HNC. The highest prevalence of pain occurred at week 4 or later during treatment for HNC (83.4%), 3 months after diagnosis (54.1%), and with metastatic disease (66%). Between 38% and 45% of patients continued to report pain 12 months after diagnosis. Pain is a critical problem in HNC during and after treatment. Early detection and intervention for pain may help patients with HNC better tolerate treatment, uncover early cancer recurrence, and improve quality of life. Research initiatives are needed to understand the biological underpinnings of chronic, post-treatment pain in HNC and develop pharmacologic and non-pharmacologic treatments. Grant support from the following sources: The Hartford Change AGEnts Initiative (supported by a grant to the Gerontological Society of American from the John A. Hartford Foundation), The Palliative Care Research Cooperative Group funded by the National Institute of Nursing Research (U24NR014637), Oncology Nursing Foundation, Johnson & Johnson Innovations, National Science Foundation (2106141), NYU Mega-Grants Initiative, and Research Challenge Fund.