Impact of dementia on cancer discovery and pain

Shuji Iritani, Mizuho Tohgi, Hiroaki Miyata, Gen Ohi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Dementia is clinically noted to influence both reporting and experience of cancer pains. However, no systemic evaluation of this aspect has been reported. The aim of the present study was to retrospectively evaluate how dementia modified the cancer discovery process, frequency of cancer pain reports and analgesic-narcotic use at a large psychiatric hospital. Methods: We reviewed all the records of cancer patients with and without dementia treated at the surgical ward of Matsuzawa Hospital from 1993 to 2004. Psychiatric diseases other than dementia, brain metastasis and alcoholism, as well as leukaemia and skin cancer, were excluded. Patients' communicativeness as to pain was ascertained from nursing records. Results: A total of 134 cancer patients with and without dementia (50 demented and 84 non-demented) were included. Demented patients were accidentally discovered to have cancer (48%) or by an unexpected unfolding of clinical signs (44%), whereas most non-demented patients (63%) voluntarily sought medical evaluation (P= 0.000). Overall, 76% of non-demented patients had cancer pains (stages I and II, 64%; stages III and IV, 84%), whereas just 22% of demented patients had cancer pains (stages I and II, 16%; stages III and IV, 26%; P= 0.000). Non-demented patients showed stage-dependent requirements for both non-narcotic analgesics (stages I and II, 64%; stages III and IV, 84%) and narcotics (stages I and II, 0%; stages III and IV, 41%). Demented patients required much less analgesics (stages I and II, 11%; stages III and IV, 13%), with only one stage IV patient requiring narcotics (P= 0.000). Conclusion: Dementia greatly modifies the cancer discovery process, reduces prevalence of cancer pain and analgesic requirement.

Original languageEnglish
Pages (from-to)6-13
Number of pages8
JournalPsychogeriatrics
Volume11
Issue number1
DOIs
Publication statusPublished - 2011 Mar
Externally publishedYes

Fingerprint

Dementia
Narcotics
Neoplasms
Analgesics
Nursing Records
Cancer Pain
Non-Narcotic Analgesics
Psychiatric Hospitals
Skin Neoplasms
Alcoholism
Psychiatry
Leukemia
Neoplasm Metastasis
Pain
Brain

Keywords

  • Analgesics
  • Cancer
  • Dementia
  • Pain

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health
  • Gerontology

Cite this

Impact of dementia on cancer discovery and pain. / Iritani, Shuji; Tohgi, Mizuho; Miyata, Hiroaki; Ohi, Gen.

In: Psychogeriatrics, Vol. 11, No. 1, 03.2011, p. 6-13.

Research output: Contribution to journalArticle

Iritani, Shuji ; Tohgi, Mizuho ; Miyata, Hiroaki ; Ohi, Gen. / Impact of dementia on cancer discovery and pain. In: Psychogeriatrics. 2011 ; Vol. 11, No. 1. pp. 6-13.
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abstract = "Background: Dementia is clinically noted to influence both reporting and experience of cancer pains. However, no systemic evaluation of this aspect has been reported. The aim of the present study was to retrospectively evaluate how dementia modified the cancer discovery process, frequency of cancer pain reports and analgesic-narcotic use at a large psychiatric hospital. Methods: We reviewed all the records of cancer patients with and without dementia treated at the surgical ward of Matsuzawa Hospital from 1993 to 2004. Psychiatric diseases other than dementia, brain metastasis and alcoholism, as well as leukaemia and skin cancer, were excluded. Patients' communicativeness as to pain was ascertained from nursing records. Results: A total of 134 cancer patients with and without dementia (50 demented and 84 non-demented) were included. Demented patients were accidentally discovered to have cancer (48{\%}) or by an unexpected unfolding of clinical signs (44{\%}), whereas most non-demented patients (63{\%}) voluntarily sought medical evaluation (P= 0.000). Overall, 76{\%} of non-demented patients had cancer pains (stages I and II, 64{\%}; stages III and IV, 84{\%}), whereas just 22{\%} of demented patients had cancer pains (stages I and II, 16{\%}; stages III and IV, 26{\%}; P= 0.000). Non-demented patients showed stage-dependent requirements for both non-narcotic analgesics (stages I and II, 64{\%}; stages III and IV, 84{\%}) and narcotics (stages I and II, 0{\%}; stages III and IV, 41{\%}). Demented patients required much less analgesics (stages I and II, 11{\%}; stages III and IV, 13{\%}), with only one stage IV patient requiring narcotics (P= 0.000). Conclusion: Dementia greatly modifies the cancer discovery process, reduces prevalence of cancer pain and analgesic requirement.",
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