BOSTON — While research has shown a link between chronic pain and post-traumatic stress disorder, not much is known about the longitudinal course of pain and PTSD during cancer treatment, according to a new study.

In a report in the Journal of Palliative Medicine, researchers from the VA New England Geriatric Research Education and Clinical Center and Harvard Medicine School, as well as colleagues, described how they examined the prevalence of PTSD and chronic pain at three time periods in veterans with a diagnosis of cancer. 1

Researchers sought to determine whether there is a relationship between the experience of pain and PTSD.

For the study, 123 patients with oral-digestive cancers were recruited from the VHA; participants, who had a median age of 65.31 and were 98.4% male, completed face-to-face interviews at six, 12 and 18 months post-diagnosis.

Researchers used measures including the Post-traumatic Stress Disorder Checklist-Stressor-Specific version (PCL-S), Primary care PTSD (PC-PTSD) and the Patient-Reported Outcomes Measurement Information System (PROMIS) Pain Impact Scale.

More than one-fourth, 26.8%, of participants had chronic pain, defined as elevated pain at two time periods. About one-fifth, 20.3%, exhibited symptoms of combat-related PTSD at six months, and 22.8% endorsed symptoms of cancer-related PTSD, exceeding a clinical cutoff for older adults.

“Changes over time were observed for cancer-related PTSD symptom clusters of hyperarousal (F = 3.85 and p = 0.023) and emotional numbing (F = 4.06 and p = 0.018) with a statistically significant quadratic function increasing at 18 months,” the authors wrote. “In logistic regression, individuals with both combat and cancer-related PTSD symptoms at six months had 8.49 times higher odds of experiencing chronic pain (χ2 = 25.91 and p < 0.001; R2 = 0.28).

Researchers noted that “persisting pain may be a concern in veterans with cancer. Individuals who have experienced traumatic events with persisting PTSD symptoms may be at elevated risk for chronic pain. Veterans with PTSD symptoms from both cancer and combat are at the highest risk to experience chronic pain.”

  1. Sager ZS, Wachen JS, Naik AD, Moye J. Post-Traumatic Stress Disorder Symptoms from Multiple Stressors Predict Chronic Pain in Cancer Survivors [published online ahead of print, 2020 Mar 31]. J Palliat Med. 2020;10.1089/jpm.2019.0458. doi:10.1089/jpm.2019.0458.