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Inyang KE, Evans CM, Heussner M, Petroff M, Reimers M, Vermeer PD, Tykocki N, Folger JK, Laumet G. HPV+ head and neck cancer-derived small extracellular vesicles communicate with TRPV1+ neurons to mediate cancer pain. Pain 2024; 165:608-620. [PMID: 37678566 PMCID: PMC10915104 DOI: 10.1097/j.pain.0000000000003045] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 06/15/2023] [Indexed: 09/09/2023]
Abstract
ABSTRACT Severe pain is often experienced by patients with head and neck cancer and is associated with a poor prognosis. Despite its frequency and severity, current treatments fail to adequately control cancer-associated pain because of our lack of mechanistic understanding. Although recent works have shed some light of the biology underlying pain in HPV-negative oral cancers, the mechanisms mediating pain in HPV+ cancers remain unknown. Cancer-derived small extracellular vesicles (cancer-sEVs) are well positioned to function as mediators of communication between cancer cells and neurons. Inhibition of cancer-sEV release attenuated pain in tumor-bearing mice. Injection of purified cancer-sEVs is sufficient to induce pain hypersensitivity in naive mice that is prevented by QX-314 treatment and in Trpv1-/- mice. Cancer-sEVs triggered calcium influx in nociceptors, and inhibition or ablation of nociceptors protects against cancer pain. Interrogation of published sequencing data of human sensory neurons exposed to human cancer-sEVs suggested a stimulation of protein translation in neurons. Induction of translation by cancer-sEVs was validated in our mouse model, and its inhibition alleviated cancer pain in mice. In summary, our work reveals that HPV+ head and neck squamous cell carcinoma-derived sEVs alter TRPV1+ neurons by promoting nascent translation to mediate cancer pain and identified several promising therapeutic targets to interfere with this pathway.
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Affiliation(s)
| | - Christine M. Evans
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Matthew Heussner
- Department of Physiology, Michigan State University, East Lansing, MI, USA
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI
| | - Margaret Petroff
- Department of Pathology Michigan State University College of Veterinary Medicine, East Lansing, MI
| | - Mark Reimers
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Paola D. Vermeer
- Cancer Biology and Immunotherapies Group, Sanford Research, Sioux Falls, South Dakota
| | - Nathan Tykocki
- Department of Pharmacology and Toxicology, Michigan State University, East Lansing, MI
| | - Joseph K. Folger
- Department of Physiology, Michigan State University, East Lansing, MI, USA
| | - Geoffroy Laumet
- Department of Physiology, Michigan State University, East Lansing, MI, USA
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Ibrahim T, Wu P, Wang LJ, Fang-Mei C, Murillo J, Merlo J, Shein SS, Tumanov AV, Lai Z, Weldon K, Chen Y, Ruparel S. Sex-dependent differences in the genomic profile of lingual sensory neurons in naïve and tongue-tumor bearing mice. Sci Rep 2023; 13:13117. [PMID: 37573456 PMCID: PMC10423281 DOI: 10.1038/s41598-023-40380-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/09/2023] [Indexed: 08/14/2023] Open
Abstract
Mechanisms of sex-dependent orofacial pain are widely understudied. A significant gap in knowledge exists about comprehensive regulation of tissue-specific trigeminal sensory neurons in diseased state of both sexes. Using RNA sequencing of FACS sorted retro-labeled sensory neurons innervating tongue tissue, we determined changes in transcriptomic profiles in males and female mice under naïve as well as tongue-tumor bearing conditions Our data revealed the following interesting findings: (1) FACS sorting obtained higher number of neurons from female trigeminal ganglia (TG) compared to males; (2) Naïve female neurons innervating the tongue expressed immune cell markers such as Csf1R, C1qa and others, that weren't expressed in males. This was validated by Immunohistochemistry. (3) Accordingly, immune cell markers such as Csf1 exclusively sensitized TRPV1 responses in female TG neurons. (4) Male neurons were more tightly regulated than female neurons upon tumor growth and very few differentially expressed genes (DEGs) overlapped between the sexes, (5) Male DEGs contained higher number of transcription factors whereas female DEGs contained higher number of enzymes, cytokines and chemokines. Collectively, this is the first study to characterize the effect of sex as well as of tongue-tumor on global gene expression, pathways and molecular function of tongue-innervating sensory neurons.
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Affiliation(s)
- Tarek Ibrahim
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Ping Wu
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Li-Ju Wang
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, San Antonio, USA
| | - Chang Fang-Mei
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Josue Murillo
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Jaclyn Merlo
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA
| | - Sergey S Shein
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health San Antonio, San Antonio, USA
| | - Alexei V Tumanov
- Department of Microbiology, Immunology and Molecular Genetics, University of Texas Health San Antonio, San Antonio, USA
| | - Zhao Lai
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Korri Weldon
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Molecular Medicine, University of Texas Health at San Antonio, San Antonio, TX, USA
| | - Yidong Chen
- Greehey Children's Cancer Institute, University of Texas Health San Antonio, San Antonio, USA
- Department of Population Health Sciences, University of Texas Health at San Antonio, San Antonio, USA
| | - Shivani Ruparel
- Department of Endodontics, School of Dentistry, University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, San Antonio, TX, 78229, USA.
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Heussner MJ, Folger JK, Dias C, Massri N, Dahdah A, Vermeer PD, Laumet G. A Novel Syngeneic Immunocompetent Mouse Model of Head and Neck Cancer Pain Independent of Interleukin-1 Signaling. Anesth Analg 2021; 132:1156-1163. [PMID: 33323783 PMCID: PMC7969384 DOI: 10.1213/ane.0000000000005302] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Pain is one of the first presenting symptoms in patients with head and neck cancer, who often develop chronic and debilitating pain as the disease progresses. Pain is also an important prognostic marker for survival. Unfortunately, patients rarely receive effective pain treatment due to our limited knowledge of the mechanisms underlying head and neck cancer pain (HNCP). Pain is often associated with neuroinflammation and particularly interleukin (IL)-1 signaling. The purpose of this study is to develop a novel syngeneic model of HNCP in immunocompetent mice to examine the contribution of IL-1 signaling. METHODS Male C57BL/6 mice were injected with a murine model of human papillomavirus (HPV+)-induced oropharyngeal squamous cell carcinoma in their right hindlimb to induce tumor growth. Pain sensitivity was measured via von Frey filaments. Spontaneous pain was assessed via the facial grimace scale. IL-1β was measured by quantifying gene expression via quantitative polymerase chain reaction (qPCR) and enzyme-linked immunosorbent assay (ELISA). RESULTS Pain hypersensitivity and spontaneous pain develop quickly after the implantation of tumor cells, a time when tumor volume is still insignificant. Spinal and circulating IL-1β levels are significantly elevated in tumor-bearing mice. Blocking IL-1 signaling either by intrathecal administration of interleukin-1 receptor antagonist (IL-1ra) or by genetic deletion (interleukin-1 receptor knockout [Il1r1-/-]) does not alleviate HNCP. CONCLUSIONS We established the first syngeneic model of HNCP in immunocompetent mice. Unlike inflammatory or nerve-injured pain, HNCP is independent of IL-1 signaling. These findings challenge the common belief that pain results from tissue compression or IL-1 signaling in patients with head and neck cancer.
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Affiliation(s)
- Matthew J. Heussner
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA
| | - Joseph K. Folger
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
| | - Christina Dias
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
| | - Noura Massri
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
| | - Albert Dahdah
- Department of Microbiology & Molecular Genetics, Michigan State University, East Lansing, MI 48824, USA
| | - Paola D. Vermeer
- Cancer Biology and Immunotherapies Group, Sanford Research, Sioux Falls, SD 57104, USA
| | - Geoffroy Laumet
- Department of Physiology, Michigan State University, East Lansing, MI 48824, USA
- Department of Symptom Research, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA
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Dysphagia, voice problems, and pain in head and neck cancer patients. Eur Arch Otorhinolaryngol 2021; 278:3985-3994. [PMID: 33452920 PMCID: PMC8382612 DOI: 10.1007/s00405-020-06584-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Accepted: 12/22/2020] [Indexed: 11/12/2022]
Abstract
PURPOSE Head and neck cancer (HNC) and its treatment can leave devastating side effects with a relevant impact on physical and emotional quality of life (QoL) of HNC patients. The objectives were to examine the amount of dysphagia, voice problems, and pain in HNC patients, the impact of sociodemographic, behavioral, and clinical factors on these symptoms, the psychometric properties of the EAT-10, and the relationship between these symptoms and QoL variables. METHODS HNC patients attending for regular follow-up from 07/2013 to 09/2019 completed questionnaires (Eating Assessment Tool-10 (EAT-10); questions from the EORTC QLQ-C30 and EORTC H&N35) on dysphagia, voice problems, pain, fatigue, and QoL collected with the software OncoFunction. Associations between prognostic factors and symptoms were tested with analyses of variance (ANOVAs). Associations between the symptom scales and QoL variables were expressed with Pearson correlations. RESULTS Of 689 patients, 54.9% suffered from dysphagia, the EAT-10 proved to be a reliable measure. The mean voice score was 37.6 (± 33.9) [range 0-100], the mean pain score 1.98 (± 2.24) [range 0-10]. Trimodality treatment was associated with the highest dysphagia scores. Dysphagia, voice problems, and pain significantly correlated with each other, the highest association was found for dysphagia and pain (r = 0.51). QoL was strongly correlated with dysphagia and pain (r = - 0.39 and r = - 0.40, respectively), while the association with voice problems was weaker (r = - 0.28). CONCLUSION Dysphagia is an important symptom in HNC patients greatly affecting patients' QoL and significantly correlating with voice problems and pain.
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Alves AM, Correa MB, Silva KDD, Araújo LMAD, Vasconcelos ACU, Gomes APN, Etges A, Tarquinio SBC. Demographic and Clinical Profile of Oral Squamous Cell Carcinoma from a Service-Based Population. Braz Dent J 2018; 28:301-306. [PMID: 29297550 DOI: 10.1590/0103-6440201601257] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/14/2017] [Indexed: 11/22/2022] Open
Abstract
The aim of this study was to evaluate the demographic and clinical profile of the oral squamous cells carcinoma (OSCC) cases registered in a center of oral diagnosis in southern Brazil. Eight hundred and six individuals with OSCC from 1959 to 2012 were included in this study. The variables recorded were: sex, age, occupation according to workplace, alcohol and tobacco consumption, skin color, tumor location, histological type, clinical appearance, size, evolution time, presence of pain and lymph node metastasis. Descriptive analysis was performed and the associations between variables were assessed using the chi-square and Fisher's exact test, with a confidence level of 5%. OSSC was more common in males (76.6%) aged between 51 to 70 years (53.9%). The most frequent sites were lower lip vermilion (23.3%), tongue (20.2%) and gingiva/alveolar ridge (18.1%). There was a strong association between outdoor occupation and white skin color with lip squamous cell carcinoma (LSCC). OSCC intraoral lesions were commonly more painful, larger than 2 cm and presented lymphatic metastasis. In conclusion, most of the results confirm the data from literature about sex, age, tumor location and occupation. Moreover, the positive correlations between LSCC and occupation, between LSCC and white skin color, and between bigger lesions and presence of pain/cervical metastasis also corroborate the literature data.
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Affiliation(s)
- Alessandro Menna Alves
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Dental School, UNIVATES - Unidade Integrada Vale do Taquari de Ensino Superior, Lajeado, RS, Brazil
| | - Marcos Britto Correa
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Karine Duarte da Silva
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | | | - Ana Carolina Uchoa Vasconcelos
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Ana Paula Neutzling Gomes
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Adriana Etges
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
| | - Sandra Beatriz Chaves Tarquinio
- Graduate Program in Dentistry, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil.,Center of Diagnosis of Oral Diseases, UFPel - Universidade Federal de Pelotas, Pelotas, RS, Brazil
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miRNAs: Important Targets for Oral Cancer Pain Research. BIOMED RESEARCH INTERNATIONAL 2017; 2017:4043516. [PMID: 29214166 PMCID: PMC5682905 DOI: 10.1155/2017/4043516] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 08/28/2017] [Accepted: 09/14/2017] [Indexed: 02/07/2023]
Abstract
Pain is a symptom shared by an incredible number of diseases. It is also one of the primary conditions that prompt individuals to seek medical treatment. Head and neck squamous cell carcinoma (HNSCC) corresponds to a heterogeneous disease that may arise from many distinct structures of a large, highly complex, and intricate region. HNSCC affects a great number of patients worldwide and is directly associated with chronic pain, which is especially prominent during the advanced stages of oral squamous cell carcinoma (OSCC), an anatomical and clinical subtype that corresponds to the great majority oral cancers. Although the cellular and molecular bases of oral cancer pain have not been fully established yet, the results of recent studies suggest that different epigenetic mechanisms may contribute to this process. For instance, there is strong scientific evidence that microRNAs (miRNAs), small RNA molecules that do not encode proteins, might act by regulating the mechanisms underlying cancer-related pain. Among the miRNAs that could possibly interfere in pain-signaling pathways, miR-125b, miR-181, and miR-339 emerge as some of the most promising candidates. In fact, such molecules apparently contribute to inflammatory pain. Moreover, these molecules possibly influence the activity of endogenous pain control systems (e.g., opioidergic and serotonergic systems), which could ultimately result in peripheral and central sensitization, central nervous system (CNS) phenomena innately associated with chronic pain. This review paper focuses on the current scientific knowledge regarding the involvement of miRNAs in cancer pain, with special attention dedicated to OSCC-related pain.
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Oliveira MLC, Wagner VP, Sant'ana Filho M, Carrard VC, Hugo FN, Martins MD. A 10-year analysis of the oral squamous cell carcinoma profile in patients from public health centers in Uruguay. Braz Oral Res 2015; 29:S1806-83242015000100270. [PMID: 26083090 DOI: 10.1590/1807-3107bor-2015.vol29.0075] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2014] [Accepted: 02/20/2015] [Indexed: 01/10/2023] Open
Abstract
The aim of this study was to evaluate the demographic, clinical, and therapeutic characteristics and predictive factors of poor prognosis in patients with primary oral squamous cell carcinoma (OSCC) in Uruguay. Medical records of patients with the diagnosis of primary OSCC treated between 2000 and 2010 in Uruguayan public hospitals were selected. Data on demographic characteristics, risk factors, clinical features, treatment, and outcome were collected. Associations of independent variables with outcomes were assessed using Pearson chi-squared and Fisher's tests. Of 200 patients with OSCC, 79.4% were men (3.8:1 male:female ratio), with a mean age of 60.75 ± 11.26 years. Tobacco and alcohol consumption were reported by 85.3% and 63.5% of patients, respectively. The most commonly affected location was the tongue (42.5%), with lesions exhibiting ulcerous aspects in 87.9% of cases and pain at the time of diagnosis in 70.4% of cases. One hundred sixty-one (82.1%) patients had advanced-stage (III/IV) OSCC. Surgery was the most common treatment option, and the overall 5-year survival rate was 58.5%. Univariate analysis showed that the predictors of poor prognosis were clinical aspect, size, regional metastasis, clinical stage, and treatment. In Uruguay, OSCC is diagnosed late, which is associated with a low survival rate. Educational and preventive measures and investment to improve early diagnosis should be undertaken.
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Affiliation(s)
| | - Vivian Petersen Wagner
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Manoel Sant'ana Filho
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Vinicius Coelho Carrard
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Fernando Neves Hugo
- Center of Community Dental Health Research, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
| | - Manoela Domingues Martins
- Department of Oral Pathology, School of Dentistry, Universidade Federal do Rio Grande do Sul, Porto Alegre, RS, Brazil
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Oliveira KG, von Zeidler SV, Lamas AZ, Podestá JRVD, Sena A, Souza ED, Lenzi J, Lemos EM, Gouvea SA, Bissoli NS. Relationship of inflammatory markers and pain in patients with head and neck cancer prior to anticancer therapy. ACTA ACUST UNITED AC 2014; 47:600-4. [PMID: 25003634 PMCID: PMC4123840 DOI: 10.1590/1414-431x20143599] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Accepted: 03/12/2014] [Indexed: 12/29/2022]
Abstract
Pain is a common symptom in patients with cancer, including those with head and neck cancer (HNC). While studies suggest an association between chronic inflammation and pain, levels of inflammatory cytokines, such as C-reactive protein (CRP) and tumor necrosis factor-alpha (TNF-α), have not been correlated with pain in HNC patients who are not currently undergoing anticancer treatment. The purpose of this study was to examine the relationship between these inflammatory markers and perceived pain in HNC patients prior to anticancer therapy. The study group consisted of 127 HNC patients and 9 healthy controls. Pain was assessed using the Brief Pain Inventory (BPI), and serum levels of CRP and TNF-α were determined using the particle-enhanced turbidimetric immunoassay (PETIA) and ELISA techniques, respectively. Patients experiencing pain had significantly higher levels of CRP (P<0.01) and TNF-α (P<0.05) compared with controls and with patients reporting no pain. There were significantly positive associations between pain, CRP level, and tumor stage. This is the first study to report a positive association between perceived pain and CRP in HNC patients at the time of diagnosis. The current findings suggest important associations between pain and inflammatory processes in HNC patients, with potential implications for future treatment strategies.
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Affiliation(s)
- K G Oliveira
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - S V von Zeidler
- Departamento de Patologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - A Z Lamas
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - J R V de Podestá
- Divisão de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, ES, Brazil
| | - A Sena
- Divisão de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, ES, Brazil
| | - E D Souza
- Divisão de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, ES, Brazil
| | - J Lenzi
- Divisão de Cabeça e Pescoço, Hospital Santa Rita de Cássia, Vitória, ES, Brazil
| | - E M Lemos
- Centro de Doenças Infecciosas, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - S A Gouvea
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
| | - N S Bissoli
- Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES, Brasil
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Rogers SN, Cleator AJ, Lowe D, Ghazali N. Identifying pain-related concerns in routine follow-up clinics following oral and oropharyngeal cancer. World J Clin Oncol 2012; 3:116-25. [PMID: 22905338 PMCID: PMC3421024 DOI: 10.5306/wjco.v3.i8.116] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/14/2012] [Accepted: 08/02/2012] [Indexed: 02/06/2023] Open
Abstract
AIM: To describe clinical characteristics of head and neck cancer (HNC) patients with pain and those wishing to discuss pain concerns during consultation.
METHODS: Cross-sectional, questionnaire study using University of Washington Quality of Life, version 4 (UW-QOL) and the Patients Concerns Inventory (PCI) in disease-free, post-treatment HNC cohort. Significant pain on UW-QOL and indicating “Pain in head and neck” and “Pain elsewhere” on PCI.
RESULTS: One hundred and seventy-seven patients completed UW-QOL and PCI. The prevalence of self-reported pain issues was 38% (67/177) comprising 25% (44/177) with significant problems despite medications and 13% (23/177) with lesser or no problems but wishing to discuss pain. Patients aged under 65 years and patients having treatment involving radiotherapy were more likely to have pain issues. Just over half, 55% (24/44) of patients with significant pain did not express a need to discuss this. Those with significant pain or others wanting to discuss pain in clinic had greater problems in physical and social-emotional functioning, reported suboptimal QOL, and also had more additional PCI items to discuss in clinic compared to those without significant pain and not wishing to discuss pain.
CONCLUSION: Significant HNC-related pain is prevalent in the disease-free, posttreatment cohort. Onward referral to a specialist pain team may be beneficial. The UW-QOL and PCI package is a valuable tool that may routinely screen for significant pain in outpatient clinics.
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Affiliation(s)
- Simon N Rogers
- Simon N Rogers, Derek Lowe, Naseem Ghazali, Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, L9 7LN, United Kingdom
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Shoor H, Mutalik S, Pai KM. Should pain be used as predictor of prognosis in oral squamous cell carcinomas? Oral Surg Oral Med Oral Pathol Oral Radiol 2012; 113:423; author reply 424. [PMID: 22669150 DOI: 10.1016/j.oooo.2011.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 08/30/2011] [Indexed: 10/14/2022]
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11
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Macfarlane TV, Wirth T, Ranasinghe S, Ah-See KW, Renny N, Hurman D. Head and neck cancer pain: systematic review of prevalence and associated factors. J Oral Maxillofac Res 2012; 3:e1. [PMID: 24422003 PMCID: PMC3886092 DOI: 10.5037/jomr.2012.3101] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2011] [Accepted: 02/23/2012] [Indexed: 02/06/2023]
Abstract
OBJECTIVES Pain is a major symptom in patients with cancer; however information on head and neck cancer related pain is limited. The aim of this review was to investigate the prevalence of pain and associated factors among patients with HNC. MATERIAL AND METHODS The systematic review used search of MEDLINE, EMBASE and CINAHL databases to December 2011. Cancers of the oral mucosa, oropharynx, hypopharynx and larynx were included in this review with pain as main outcome. The review was restricted to full research reports of observational studies published in English. A checklist was used to assess the quality of selected studies. RESULTS There were 82 studies included in the review and most of them (84%) were conducted in the past ten years. Studies were relatively small, with a median of 80 patients (IQR 44, 154). The quality of reporting was variable. Most studies (77%) used self-administered quality of life questionnaires, where pain was a component of the overall scale. Only 33 studies reported pain prevalence in HNC patients (combined estimate from meta-analysis before (57%, 95% CI 43% - 70%) and after (42%, 95% CI 33% - 50%) treatment. Only 49 studies (60%) considered associated factors, mostly tumour- or treatment-related. CONCLUSIONS The study has shown high levels of pain prevalence and some factors associated with higher levels of pain. There is a need for higher quality studies in a priority area for the care of patients with head and neck cancer.
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Affiliation(s)
| | - Tanja Wirth
- School of Medicine and Dentistry, University of Aberdeen, AberdeenUnited Kingdom.
- University of Bremen, BremenGermany.
| | - Sriyani Ranasinghe
- School of Medicine and Dentistry, University of Aberdeen, AberdeenUnited Kingdom.
- Postgraduate Institute of Medicine, University of ColomboSri Lanka.
| | - Kim W. Ah-See
- Department of Otolaryngology, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
| | - Nick Renny
- Department of Maxillofacial Surgery, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
| | - David Hurman
- Department of Clinical Oncology, Aberdeen Royal Infirmary, AberdeenUnited Kingdom.
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Sato J, Yamazaki Y, Satoh A, Onodera-Kyan M, Abe T, Satoh T, Notani KI, Kitagawa Y. Should pain be used as predictor of prognosis in oral squamous cell carcinomas. Oral Surg Oral Med Oral Pathol Oral Radiol 2012. [DOI: 10.1016/j.oooo.2011.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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