Colorectal cancer pain upon diagnosis and after treatment: a cross-sectional comparison with healthy matched controls

• Published in: Supportive care in cancer Vol. 30; no. 4; pp. 3573 - 3584
• Main Authors: Lopez-Garzon, Maria, Postigo-Martin, Paula, González-Santos, Ángela, Arroyo-Morales, Manuel, Achalandabaso-Ochoa, Alexander, Férnández-Pérez, Antonio Manuel, Cantarero-Villanueva, Irene
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01-04-2022; Springer; Springer Nature B.V
• Subjects: Abdomen; Body Composition; Cancer; Cancer pain; Cancer Pain - diagnosis; Cancer Pain - etiology; Care and treatment; Colorectal cancer; Colorectal Neoplasms - complications; Colorectal Neoplasms - diagnosis; Comparative analysis; Cross-Sectional Studies; Diagnosis; Humans; Hyperalgesia; Medical diagnosis; Medicine; Medicine & Public Health; Muscles; Nursing; Nursing Research; Oncology; Original; Original Article; Pain; Pain Medicine; Pain Threshold - physiology; Physiological aspects; Rehabilitation Medicine; Cancer pain; Muscle strength; Pain measurement; Body composition; Colorectal cancer
• ISSN: 0941-4355; 1433-7339
• DOI: 10.1007/s00520-022-06803-2

Background
The current study sought to explore whether cancer pain (CP) already exists in patients at colorectal cancer (CRC) diagnosis before treatment compared with patients with colorectal cancer (CRC) after treatment and a healthy matched control group. The study also sought to examine whether factors related to physical health status could enhance pain processes.
Methods
An observational cross-sectional study was conducted following the STROBE checklist. Twenty-nine newly diagnosed and forty post-treatment patients with CRC and 40 healthy age/sex-matched controls were included for comparison. Pain, local muscle function, and body composition outcomes were assessed by a physiotherapist with > 3 years of experience. ANCOVA and Kruskal–Wallis tests were performed, with Bonferroni and Dunn-Bonferroni post hoc analyses and Cohen’s
d
and Hedge’s effect size, as appropriate.
Results
The analysis detected lower values of pressure pain threshold (PPT) points, the PPT index, and abdominal strength and higher values of self-reported abdominal pain in newly diagnosed patients, with even more marked results observed in the post-treatment patients, where lower lean mass and skeletal muscle index values were also found than those in the healthy matched controls (
p
 < 0.05). In the post-treatment and healthy matched control groups, positive associations were observed between the PPT lumbar dominant side points and abdominal isometric strength and lean mass, and negative associations were observed between the lumbar dominant side points and body fat (
p
 < 0.05).
Conclusion
Upon diagnosis, patients with CRC already show signs of hyperalgesia and central sensitization and deteriorated physical conditions and body composition, and this state could be aggravated by subsequent treatments.