Original Article
Copyright ©2012 Baishideng. All rights reserved.
World J Clin Oncol. Aug 10, 2012; 3(8): 116-125
Published online Aug 10, 2012. doi: 10.5306/wjco.v3.i8.116
Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer
Simon N Rogers, Alexander J Cleator, Derek Lowe, Naseem Ghazali
Simon N Rogers, Derek Lowe, Naseem Ghazali, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 7LN, United Kingdom
Simon N Rogers, Derek Lowe, Evidence-Based Practice Research Centre, Faculty of Health, Edge Hill University, St Helens Road, Ormskirk, L39 4QP, United Kingdom
Alexander J Cleator, Faculty of Medicine, University of Liverpool, Duncan Building, Daulby Street, Liverpool, L69 3GA, United Kingdom
Author contributions: Rogers SN was involved in developing study concepts and design; data collection, analysis and interpretation; quality control of data and algorithms, manuscript preparation, editing and review; Cleator AJ was involved in data collection and manuscript preparation; Lowe D was involved in developing study concepts and design, data analysis and interpretation, quality control of data and algorithms; statistical analysis, manuscript preparation, editing and review; Ghazali N was involved in manuscript preparation, editing and review.
Correspondence to: Simon N Rogers, MD, FDS, RCS, FRCS, Professor, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 7LN, United Kingdom. snrogers@doctors.co.uk
Telephone: +44-151-5295287 Fax: +44-151-5295288
Received: May 9, 2012
Revised: June 14, 2012
Accepted: August 2, 2012
Published online: August 10, 2012

AIM: To describe clinical characteristics of head and neck cancer (HNC) patients with pain and those wishing to discuss pain concerns during consultation.

METHODS: Cross-sectional, questionnaire study using University of Washington Quality of Life, version 4 (UW-QOL) and the Patients Concerns Inventory (PCI) in disease-free, post-treatment HNC cohort. Significant pain on UW-QOL and indicating “Pain in head and neck” and “Pain elsewhere” on PCI.

RESULTS: One hundred and seventy-seven patients completed UW-QOL and PCI. The prevalence of self-reported pain issues was 38% (67/177) comprising 25% (44/177) with significant problems despite medications and 13% (23/177) with lesser or no problems but wishing to discuss pain. Patients aged under 65 years and patients having treatment involving radiotherapy were more likely to have pain issues. Just over half, 55% (24/44) of patients with significant pain did not express a need to discuss this. Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning, reported suboptimal QOL, and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain.

CONCLUSION: Significant HNC-related pain is prevalent in the disease-free, posttreatment cohort. Onward referral to a specialist pain team may be beneficial. The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.

Keywords: Pain, Health related quality of life, Patient Concerns Inventory, Head and neck cancer, Mouth neoplasm, Quality of life, Questionnaire