Abstract
Pain, and especially cancer pain, is not a pure nociceptive, physical experience, but involves different dimensions of man, such as personality, affect, cognition, behavior and social relations. Cancer pain is best conceptualized as the convergence of multiple activated systems with feedback mechanisms to a complex, multidimensional model. The psychosocial aspects of this multidimensional model will be analyzed with special emphasis on results from recent research. Although most research has been conducted on the role of affect and cognition in cancer pain, data on other factors such as personality, behavior or social aspects exist and will be presented. In the second part of this paper the implications of these results for therapeutic strategies in clinical work will be discussed. Although a considerable body of knowledge exists to support the hypothesis of a multidimensional model of cancer pain, where psychosocial variables play an important role, only a few studies address the issue of to what degree different factors exercise their influence. This may be different from patient to patient and may change over the course of the disease. Whatever importance these single variables in the multidimensional model of cancer pain may have, the patient is best treated when none of these aspects is neglected in the assessment and all are taken care of in the treatment. A multidisciplinary team, with a psychiatrist as one of the team members, is often best prepared to fulfill this task.
Article PDF
Similar content being viewed by others
Avoid common mistakes on your manuscript.
References
Ahles TA (1985) Psychological approaches to the management of cancer-related pain. Semin Oncol Nurs 1:141–146
Ahles TA, Blanchard EB, Ruckdeschel JC (1983) The multidimensional nature of cancer-related pain. Pain 17:277–288
Bond MR (1971) The relation of pain to the Eysenek personality inventory, Cornell Medical Index and Whiteley Index of hypochondriasis. Br J Psychiatry 119:671–678
Bond MR (1981) The value of psychological analysis of clinical pain problems. Schweiz Med Wochenschr 111:1941–1946
Breitbart W (1989) Psychiatric management of cancer pain. Cancer 63:2336–2342
Charap AD (1978) The knowledge, attitudes, and experience of medical personnel treating pain in the terminally ill. Mt Sinai J Med 45:561–580
Cleeland CS (1984) The impact of pain on the patient with cancer. Cancer 54:2635–2641
Cleeland CS (1987) Nonpharmacological management of cancer pain. J Pain Symptom Manage 2:S23-S28
Dalton JA, Feuerstein M (1989) Fear alexithymia and cancer pain. Pain 38:159–170
Derogatis LR, Morrow GR, Fetting J, et al (1983) The prevalence of psychiatric disorders among cancer patients. JAMA 249:751–757
Dorrepaal KL, Aaronson NK, Dam FS van (1989) Pain experience and pain management among hospitalized cancer patients. Cancer 63:593–598
Fields HL (ed) (1987) Pain pathways in the central nervous system. Pain. McGraw-Hill, New York, pp 41–78
Fishman B, Loscalzo M (1987) Cognitive-behavioral intervention in management of cancer pain: principles and applications. Med Clin North Am 71:271–287
Fishman B, Pasternak S, Wallenstein SL, et al (1987) The memorial pain assessment card: a valid instrument for the assessment of cancer pain. Cancer 60:1151–1158
Grossman SA, Sheidler VR, Swedeen K, Mucenski J, Piantadosi S (1991) Correlation of patient and caregiver ratings of cancer pain. J Pain Symptom Manage 6:53–57
Hill HF, Saeger LC, Chapman CR (1986) Patient controlled analgesia after bone marrow transplantation for cancer. Postgrad Med 40:33–40
Kremer EF, Atkinson JH, Ignelzi RJ (1982) Pain measurement: the affective dimensional measure of the McGill pain questionnaire with a cancer pain population. Pain 12:153–163
Levin DN, Cleeland CS, Reuven D (1985) Public attitudes toward cancer pain. Cancer 56:2337–2339
Lindblom U, Merskey H, Mumford JM, Nathan PW, Noordenbos W, Sunderland S (1986) Pain terms: a current list with definitions and notes on usage. Pain 3 (Suppl):S215-S221
Marks RM, Sachar EJ (1973) Undertreatment of medical inpatients with narcotic analgesics. Ann Intern Med 78:173–181
Nehemkis AM, Charter RA, Stampp MS, Gerber KE (1983) Reattribution of cancer pain. Int J Psychiatry Med 12:213–227
Peteet J, Tay V, Cohen G, Macintyre J (1986) Pain characteristics and treatment in an outpatient cancer population. Cancer 57:1259–1265
Saltzburg A, Breitbart W, Fishman B, Stiefel F, Holland J, Foley K (1989) The relationship of pain and depression to suicidal ideation in cancer patients (abstract). Proc Am Soc Clin Oncol Annu Meet 8:312
Senn HJ, Glaus A, Morant R (1991) Eröffnung einer onkologischen Palliativstation im Rahmen des Tumorzentrums am Kantonsspital St. Gallen. Schweiz Ärzteztg 72:1091–1093
Spiegel D, Bloom J (1983) Pain in metastatic breast cancer. Cancer 52:341–345
Stiefel F, Volkenandt M, Breitbart W (1989) Suizid und Krebserkrankung. Schweiz Med Wochenschr 119:891–895
Stiefel F, Volkenandt M, Breitbart W (1989) Schmerzen bei Tumorpatienten und Indikationen für Psychopharmaka. Schweiz Rundsch Med Prax 51:1440–1444
Stiefel F, Kornblith A, Holland J (1990) Psychotropic drugs prescribed for cancer patients: changes over a decade. Cancer 65:1048–1053
Strang P, Qvarner H (1990) Cancer-related pain and its influence on quality of life. Anticancer Res 10:109–112
Weissman DE, Dahl JL (1990) Attitudes about cancer pain: a survey of Wisconsin's first-year medical students. J Pain Symptom Manage 5:345–349
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Stiefel, F. Psychosocial aspects of cancer pain. Support Care Cancer 1, 130–134 (1993). https://doi.org/10.1007/BF00366058
Issue Date:
DOI: https://doi.org/10.1007/BF00366058