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

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

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.

Original languageEnglish (US)
Article number28
JournalSupportive Care in Cancer
Volume31
Issue number1
DOIs
StatePublished - Jan 2023
Externally publishedYes

Keywords

  • Cancer-related distress
  • Cognitive behavioral stress management
  • Functional well-being
  • Physical well-being
  • Prostate cancer

ASJC Scopus subject areas

  • Oncology

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