Depression and anxiety predict postsurgical pain in women with gynecologic cancer
CHICAGO, IL— Depression and anxiety, not just inflammation, predict pain intensity and interference with daily life among women recovering from gynecologic cancer surgery, according to findings from a longitudinal, prospective study, presented at the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting.
“Our results suggest that depression, anxiety and inflammation may exacerbate pain following surgery for gynecologic cancer,” concluded lead author Kelsey Honerlaw of the University of Wisconsin's School of Medicine and Public Health in Madison, Wisconsin, and coauthors. “Interventions that target these risk factors could improve postsurgical recovery and enhance overall quality of life for these women.”
A total of 90 participants undergoing ovarian or endometrial cancer surgery completed validated self-report questionnaires describing pain intensity and interference with daily life, depression and anxiety, at 1 week, 1 month and 4 months after surgery.
Circulating inflammatory cytokines were measured at the same points in time.
”Pain continues to improve throughout the recovery period, with pain intensity stabilizing by 1 month post-surgery,” Honerlaw said. “Participants who reported greater depression and anxiety experienced greater pain intensity (P < .001). The same pattern was seen for pain interference.”
Patients with higher IL-6 cytokines also reported higher levels of pain intensity (P < .001), but not pain interference with daily activities, the authors reported.
All analyses were corrected for time since surgery and surgical method (laparoscopy vs laparotomy), tumor stage, age, and body mass index.