Cancer experience worse for young adults despite better survival odds
University of Michigan Health System studies cancer experience across the lifespan and reveals more pain flares and financial issues for young adults.
Young adult cancer patients have the most difficulty coping with the pain and emotional issues of cancer, in spite of their potentially better survival odds, according to a University of Michigan Health System study.
The study, which included mostly breast and lung cancer patients, appears in the November issue of Pain Medicine, a journal of the American Academy of Pain Medicine.
Adult cancer patients age 40 and under had more pain flares and more difficulty thinking quickly and logically six months after their diagnosis compared to older adults.
Cancer pain is common, whether it is consistent discomfort or patient flares that interrupt well-controlled pain.. International studies suggest nearly 70 percent of people dying from cancer experience unrelieved pain.
"Our study provides evidence for the significant toll of cancer pain on overall health and well-being of young and old adults alike, but demonstrate an increased toll for younger adults, especially financially," says study lead author Carmen R. Green, M.D., a U-M anesthesiologist and pain medicine specialist.
In the study, researchers revealed a trend of younger groups having pain in more locations---4.5 locations compared to 2.2 for older adults---up to six months after diagnosis.
Older adults reported mostly spinal pain, and younger adults reported pain in the spine, back, arms, abdomen and elsewhere, according to the study.
Perhaps as a result of their lower incomes, young adult cancer patients had more difficulty paying health care bills.
In the survey, 75 percent of young patients reported having trouble playing for health care which was twice the rate reported by older adults.
Green along with co-author Tamera Hart-Johnson, M.S., senior research associate at U-M, surveyed about 100 patients with advanced stages of breast, lung, colorectal and prostate cancer, and multiple myeloma, a bone marrow cancer.
Among the cancer patients, the youngest group, those age 40 and younger, had the greatest pain interference but improved over time, according to the study.
For example, 8 percent of young adults said pain affected their mood compared to 4.35 percent of adults in the 41-59 age group, and 4.14 percent among those age 60 and older.
"The groups did not look different mentally or emotionally at the time of diagnosis, although both cognitive functioning and depression worsened for young adults by six months as their treatments and battle with cancer continued," Green says.
The oldest group had better emotional functioning at the start, but by six months had significantly worse physical functioning.
Future studies should attempt to determine how patient age influences patient preferences and attitudes about cancer pain management.