(0614) Cancer Associated Phychological Distress and Pain in Head and Neck Cancer Patients

Introduction: Head and Neck Squamous Cell Carcinoma (HNSCC) is associated with worse pain, stress, and quality of life, than other cancers. The objective of our study is to explore the relationship between HNSCC patient-reported pain and psychological symptom burden prior to surgery.

Methods: This prospective, cohort study included patients diagnosed with squamous cell carcinoma of the oral cavity and oropharynx who underwent surgery between July 2020 and December 2023. Baseline general head and neck (HN) and oral pain (Brief Pain Inventory, University of California San Francisco Oral Cancer Pain Questionnaire, respectively), depression [Patient Health Questionnaire (PHQ-8)], and anxiety [Generalized Anxiety Disorder-7 (GAD-7)] were included in the analysis. Multivariable regression was used to investigate the association between pain scores and anxiety/depression while controlling for sex, age, and tumor staging.

Results: A total of 70 participants were analyzed, of which a majority had oral cavity cancer (mean [standard deviation]: 65 [91.5%]), with a tumor stage of T1-2 (45 [64.3%]) and nodal stage of N0 (45 [64.3%]). After controlling for age, sex, and stage, patients with higher levels of oral pain (p = 0.004, beta = 0.804, 95% CI [0.254, 1.355]) or general head and neck pain at its worst in the last 24 hours (p = 0.034, beta = 0.498, 95% CI [0.038, 0.957]) were more likely to experience higher levels of depression. Higher levels of oral pain (p = 0.1, beta = 0.437, 95% CI [-0.083, 0.958]) or general head and neck pain at its worst in the last 24 hours (p = 0.244, beta = 0.25, 95% CI [-0.17, 0.67]) were not associated with higher levels of anxiety.

Conclusions: Higher levels of depression were strongly associated with higher levels of HNSCC-related oral and general head and neck pain.