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Gynecol Oncol. 2016 Feb;140(2):301-6. doi: 10.1016/j.ygyno.2015.09.005. Epub 2015 Sep 10.

Biopsychosocial predictors of pain among women recovering from surgery for endometrial cancer.

Author information

1
Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States.
2
Department of Obstetrics and Gynecology, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, United States.
3
Department of Psychology, University of Wisconsin-Madison, Madison, WI, United States.
4
Department of Psychiatry, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, United States; Carbone Cancer Center, University of Wisconsin-Madison, Madison, WI, United States. Electronic address: ecostanzo@wisc.edu.

Abstract

OBJECTIVE:

This study investigated post-surgical changes in pain among endometrial cancer patients, as well as the extent to which emotional distress and inflammatory and regulatory cytokine levels were associated with pain.

METHODS:

Women (N=71) who underwent surgery for endometrial cancer completed questionnaires assessing pain intensity and interference, depression, and anxiety at 1week, 4weeks, and 16weeks post-surgery. Participants also provided a blood sample for the analysis of a panel of 7 cytokines at the same time points.

RESULTS:

Participants showed significant declines in pain intensity and pain interference from 1week to 4weeks post-surgery, after which pain remained stable. After adjusting for time since surgery, surgery type, adjuvant therapy, disease stage, age, and BMI, mixed-effects linear regression models indicated that greater depression and anxiety were associated with both greater pain intensity and interference. Higher levels of circulating IL-6 were also correlated with greater pain intensity, but not interference. Fixed-effects linear regression models indicated that temporal variation in depression, anxiety, and IL-6 within individual patients was associated with corresponding changes in pain. Pain symptoms were maximal when anxiety, depression, and IL-6 were highest. No other cytokines were associated with changes in pain.

CONCLUSION:

These findings indicate that depression, anxiety, and IL-6 may exacerbate pain during the recovery period following surgery for a gynecologic malignancy. Targeting these psychological processes and the proinflammatory cytokine IL-6 in women with more severe and persistent pain may help to reduce suffering and improve post-surgical recovery.

KEYWORDS:

Anxiety; Depression; Endometrial cancer; Inflammation; Pain

PMID:
26363211
PMCID:
PMC4724440
DOI:
10.1016/j.ygyno.2015.09.005
[Indexed for MEDLINE]
Free PMC Article

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