Page 66 - JCBP-3-2

Journal of Clinical and
Basic Psychosomatics Evaluation of biopsychosocial factors

It is well recognized that a weakened psychosomatic affect emotional well-being and have been linked to the
system can influence both the pathology and the success development of anxiety and depression. In addition
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of its treatment. However, in the field of oncology, the to sleep disturbances, the present study included other
2-5
extent to which these different factors interact remains variables, such as loss of self-sufficiency, changes in
unclear, requiring further analysis and new data to better activities of daily living (ADL), marital status, and lack
understand these relationships. This gap in knowledge of family and social support, all of which may be directly
led to our research, which employed multidimensional or indirectly related to anxiety and depression. These
questionnaires to assess 120 cancer patients. psychological aspects can interfere with pain perception,
Meta-analyses conducted over the last decade have cancer treatment outcomes, disease progression, and even
concluded that 40% of cancer patients continue to mortality. 15
experience significant pain even after curative treatment. Chronic pain and depressive symptoms often coexist
This figure increases to 55.0% during specific surgical, as part of a sequence of events that are frequently not
chemotherapy, and radiotherapy treatments and recognized as cause and effect. 16,17 Chronic pain can trigger
approximately 66% in cases of metastatic, advanced, or depressive symptoms, while psychological distress can
16
terminal disease. In terms of moderate to severe pain, also lead to pain. 16,17 As a result, individuals may become
as measured on the Numerical Rating Scale (>5), global trapped in a cycle of emotional distress and physical pain,
evaluations have shown a reduction in prevalence from with each element exacerbating the other. This reciprocal
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38% to 30.6% over the past decade. This data represents relationship has a physiological basis, as both symptoms
3
2
a significant decline of around 8% points in both the share common neurological pathways involving dysfunction
prevalence and severity of cancer pain. 3 in the noradrenergic and serotonergic systems. 19
From a demographic perspective, a recent large-scale As part of this vicious cycle, other comorbidities
study in Portugal reported that 38% of the population interfere with the onset, exacerbation, or persistence of
4
suffers from chronic pain. This study further revealed that these symptoms. Together, these factors contribute to a
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4
moderate to severe pain affects 50% of the sample, with 17% worsening baseline state of anxiety and depression, which
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diagnosed with depression and more than 20% reporting a can, in turn, lower the pain threshold. Some studies have
4,5
lack of pleasure in life. Others studies have indicated a identified factors that can aggravate the development of
higher prevalence of chronic pain among women and the psychological distress. However, despite the wide variety of
6,7
elderly, compared to the 10 – 30% range observed across available therapies, many patients suffering from chronic
8
Europe. 9-11 pain still consider their pain undertreated due to the
psychological nature of their problems. 9,20,22 Therefore, a
Given that a relevant number of cancer patients
continue to experience significant pain, improving cancer holistic, multidisciplinary, and biopsychosocial treatment
approach is important. Often, addressing any one
pain management remains a priority. In addition, other component of the cycle can disrupt the negative chain
variables that might initially seem less relevant should also and lead to overall improvements in other symptoms.
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be studied, as they may play a crucial role in the overall However, treatment must be highly individualized. Thus,
improvement of patient care. This study identifies some of it is crucial that, from the first consultation at a Chronic
these variables that can significantly impact QoL.
Pain Clinic, clinicians not only identify the patient’s
The complexity of oncological pathology makes it global symptoms but also initiate multimodal therapy
particularly challenging to assess the relationship between aimed at improving sleep, anxiety, and depression. This
the various symptoms associated with cancer pain. Cancer, approach often reduces the need for analgesics in the
10
as an oncological entity, encompasses a range of related treatment of chronic pain. 24,25 In cancer patients, pain
symptoms due to shared underlying factors. Inflammation is a predominant symptom that strongly interferes with
2
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has been identified as the primary cause of many of these ADL, making comprehensive patient evaluation essential.
symptoms, including pain, fatigue, anorexia, and cachexia. Multidimensional questionnaires are valuable tools for
These symptoms result from the aberrant production of this assessment. A lack of self-sufficiency in daily activities,
cytokines by cancer cells and the immune system. In the combined with inadequate home care, can lead to or
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presence of cancer pain, the biopsychosocial dimensions worsen depression and anxiety in cancer patients. 25
are also significantly impacted, making it crucial to identify The results of our study highlight the importance
the variables that may interfere with QoL. 1
of social assistance in promoting individual autonomy
It is already known that sleep disorders are directly to reduce the development of psychological distress.
9,26
associated with the psychological impact of cancer. They Another critical aspect is the need to assess the increased

Volume 3 Issue 2 (2025) 60 doi: 10.36922/jcbp.4097