The characteristics and associations of pelvic pain in gynecologic cancer patients: A single institution study

Abstract

Objectives: To explore the incidence and characteristics of pelvic pain in cancer patients attending a single institution cancer center. Methods: A cross-sectional study was undertaken consisting of a sixpage survey distributed to a random sample of patients attending this comprehensive cancer center. The survey contained anonymous self-reported demographic, treatment, lifestyle characteristics, Quality of Life (QOL), and pelvic pain inquiries that were randomly distributed to cancer patients. The QOL data collected was the Functional Assessment of Cancer Therapy — General (FACT-G) in addition to a previously validated female pelvic pain survey. FACT-G and Pain scores, along with subdomains, were compared by patient descriptive variables (exercise, diet, BMI, stage, disease status, treatment) using two-group t-tests or Analysis of Variance. Results: Over the course of 1 year, 124 cancer patients completed this survey of which 105 were female and thus completed the pelvic pain survey. 68% (N= 68) of patients who completed the pelvic pain survey (N= 100) had gynecologic cancers. The non-gynecologic cancers represented included brain, breast, colon, and esophageal cancers. The majority of patientswere in the 61–70 age range,with roughly 80% being English-speaking (N= 83). Approximately half of the patients reported receiving chemotherapy and/or radiation. The stages were distributed as follows however 32% (N= 35) of patients did not report a stage: 23% stage I, 24% stage II, 34% stage III, 19% stage IV. 25% of the patients report never exercising and 50% report eating 1–2 servings of fruits and/or vegetables per day. Of a total possible score of 45 and individual total scores of 23, 10 and 12 for pain, urinary andQOL impact respectively, this group of patients had a mean overall score of 12.30 (±9.48) with 4.75 (±5.66), 2.27 (±2.48) and 5.40 (±3.61) for pain, urinary and QOL impact subscales. In multivariate analysis pelvic pain (P b 0.0005) and less exercise (P = 0.01) were associated with poorer QOL. In this group of patients, pelvic pain was more likely to be associated with the gynecologic cancer patients (P b 0.05) and in patientswith a BMI N 30. In addition the pelvic pain scores were significantly associated with individual quartiles of the FACT-G (P = 0.0001). Conclusions: Data collected in this study demonstrates that pelvic pain scores are poor in this population. Pelvic pain is associated with infrequent exercise, poor QOL, gynecologic cancers, and higher BMI. There is a direct correlation of pelvic pain to the FACT-G total scores.