Widespread Pain Could Warn of Cancer

But researchers can't explain the association

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HealthDay Reporter

WEDNESDAY, June 4, 2003 (HealthDayNews) -- Could widespread pain be a warning sign of cancer?

British researchers think it might be.

After following more than 6,000 people for nine years, researchers from the University of Manchester found those who reported having widespread pain at the start of the study were much more likely to have been diagnosed with cancer by the end of the study.

They were also less likely to survive their cancer, according to the study, published in the June issue of Arthritis and Rheumatism.

"We found that those who originally had widespread pain had a 60 percent increased risk of getting cancer and, if they did get cancer, their survival was poorer," says study author Dr. Gary Macfarlane, an epidemiology professor at the university.

But, Macfarlane cautions, this could be a "chance" finding. He says the results need to be duplicated before a link between pain and the development of cancer can be confirmed.

During 1991 and 1992, the researchers recruited 6,331 people between the ages of 18 and 85 who had never been diagnosed with cancer for the study.

Fifteen percent of the group reported having widespread pain, such as persistent, achy joints all over. About 48 percent reported having regional pain, and 37 percent of the study participants said they had no pain.

The average age of those with widespread pain was 55 years, and 66 percent were female. Of those reporting regional pain, 58 percent were female, and the average age was 49 years. Fifty-four percent of the no-pain group was female and the average age was 42.

At the end of the nine-year period, 395 people had developed cancer -- 90 from the widespread pain group, 198 from the regional pain group and 107 from the no-pain group.

According to the study, people with regional pain are about 20 percent more likely than people with no pain to develop cancer and people who reported widespread pain were 60 percent more likely to develop cancer.

The association between widespread pain and cancer was strongest for breast cancer, but was also significantly increased for prostate, lung and large bowel cancer.

People with widespread pain who went on to develop cancer also had poorer outcomes than those without pain. They were more likely to die from their cancers, especially breast and prostate cancer.

Macfarlane says the researchers don't know how to explain these findings.

Dr. Todd Schlifstein, an attending physician at the Hospital for Joint Diseases at New York University School of Medicine in New York City, has one theory.

"People with chronic pain may be at a higher risk for other problems, because chronic pain affects all aspects of your life," he says.

They often have trouble sleeping, can't exercise and suffer from depression or social isolation, he says. And chronic pain may also dampen the immune system, which might play a role in the development of cancer, he adds.

Schlifstein points out that people with widespread pain were probably seeking medical care for their pain. That means, he says, they probably underwent more diagnostic tests than most people do, and their cancers may have simply been picked up incidentally while doctors were searching to pinpoint the cause of the pain.

Macfarlane adds it's important for people to realize that not everyone in the study with widespread pain developed cancer. Most, in fact, did not.

So, if you're suffering from chronic pain, he says, you don't need to be worried that it's a sign you will develop cancer.

"This is an isolated finding at present and would need to be replicated before we believed that there may be a link," Macfarlane says.

More information

To learn more about cancer and pain, visit CancerPain.org or the American Cancer Society.

SOURCES: Gary Macfarlane, M.D., professor, epidemiology, University of Manchester, Manchester, U.K.; Todd Schlifstein, M.D., assistant professor, rehabilitation medicine, and attending physician, Hospital for Joint Diseases and the Rusk Institute for Rehabiliation Medicine, New York University School of Medicine and Medical Center, New York City; June 2003 Arthritis and Rheumatism

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