PAIN IN OVARIAN-CANCER PATIENTS - PREVALENCE, CHARACTERISTICS, AND ASSOCIATED SYMPTOMS

Background. The prevalence, characteristics, and impact of pain and ot her symptoms have not been studied systematically in women with ovaria n cancer. Anecdotally, pain has been associated with the onset of the disease and is a common problem among those With advanced cancer; symp toms other than pain appear to be highly prevalent. Given the profound influence of pain and other symptoms on quality of life, the evaluati on of these phenomena could provide data relevant to the clinical mana gement of these patients and advance quality of life research in the a rea of symptom assessment. Methods. Questionnaires were completed by 1 11 inpatients and 40 outpatients with ovarian cancer who were undergoi ng treatment at a cancer center. Measures included a comprehensive pai n questionnaire; the Rand Mental Health Inventory, Functional Living I ndex-Cancer; and the Memorial Symptom Assessment Scale. Results. The s ample (N = 151) represented 74% of the eligible patients. The median a ge was 55 years (range, 23-86), 82% had Stage III or IV disease at pre sentation, and 69% had active disease at the time of the survey. Pain, fatigue, and psychologic distress were the most prevalent symptoms. S ixty-two percent (N = 94) described a pain syndrome that preceded the onset or recurrence of the disease, and 42% (N = 63) reported ''persis tent or frequent pain'' during the preceding 2 weeks. The latter pain had a median duration of 2 weeks (range, less than 1 to 756 weeks) and usually was in the abdominopelvic region (80%), frequent or almost co nstant (66%), and moderate tosevere. Most patients reported moderate o r greater pain-related interference with various aspects of function, particularly activity (68%), mood (62%), work (62%), and overall enjoy ment of life (61%). Performance status, inpatient status, and unmarrie d status were significant predictors of pain presence or intensity, an d both performance status and extent of tumor were significant predict ors of pain interference with function. Conclusions. Among those with ovarian cancer, greater than 40% experienced pain that substantially u ndermined function in one half to two thirds of these patients. Impair ed performance status is associated most strongly with pain. The onset or recurrence of disease often is heralded by a stereotypic pain synd rome.