PSYCHOSOCIAL-ASPECTS OF CANCER PAIN

Pain, and especially cancer pain, is not a pure nociceptive, physical experience, but involves different dimensions of man, such as personal ity, affect, cognition, behavior and social relations. Cancer pain is best conceptualized as the convergence of multiple activated systems w ith feedback mechanisms to a complex, multidimensional model. The psyc hosocial aspects of this multidimensional model will be analyzed with special emphasis on results from recent research. Although most resear ch has been conducted on the role of affect and cognition in cancer pa in, data on other factors such as personality, behavior or social aspe cts exist and will be presented. In the second part of this paper the implications of these results for therapeutic strategies in clinical w ork will be discussed. Although a considerable body of knowledge exist s to support the hypothesis of a multidimensional model of cancer pain , where psychosocial variables play an important role, only a few stud ies address the issue of to what degree different factors exercise the ir influence. This may be different from patient to patient and may ch ange over the course of the disease. Whatever importance these single variables in the multidimensional model of cancer pain may have, the p atient is best treated when none of these aspects is neglected in the assessment and all are taken care of in the treatment. A multidiscipli nary team, with a psychiatrist as one of the team members, is often be st prepared to fulfill this task.