Poster Presentation Cancer Survivorship 2019

Pain, fatigue, information needs, and fear of cancer recurrence among adult survivors of childhood cancer (#134)

Lauren Kelada 1 2 , Claire E Wakefield 1 2 , Lauren C Heathcote 3 , Tiina Jaaniste 2 4 , Christina Signorelli 1 2 , Joanna Fardell 1 2 , Mark Donoghoe 2 , Maria McCarthy 5 6 , Melissa Gabriel 7 , Richard J Cohn 1 2
  1. Kids Cancer Centre, Sydney Children's Hospital, Randwick, NSW, Australia
  2. School of Women's and Children's Health, UNSW Sydney, Kensington, NSW, Australia
  3. Department of Anesthesiology, Perioperative, and Pain Medicine, Stanford University Medical School, Palo Alto, California, USA
  4. Department of Pain & Palliative Care, Sydney Children’s Hospital, Randwick, NSW, Australia
  5. Murdoch Children’s Research Institute, Melbourne, Victoria, Australia
  6. Children’s Cancer Centre, Royal Children’s Hospital, Melbourne, Victoria, Australia
  7. Cancer Centre for Children, The Children’s Hospital, Westmead, NSW, Australia

Pain and fatigue are two under-researched late effects of childhood cancer and its treatment, both of which have profound impacts on survivors. This study investigated the prevalence of self-reported pain and fatigue since treatment completion and anticipated future pain and fatigue. We explored how these factors related to demographic and medical characteristics, information needs, and fear of cancer recurrence. We surveyed 404 adult survivors of any form of childhood cancer (M=16.82 years since treatment completion). Many survivors reported experiencing pain (28.7%) and fatigue (40.3%) since treatment completion, and anticipated future pain (19.3%) and fatigue (26.2%), which were all significantly associated with one another (all p's <.001). Bone or soft tissue sarcoma diagnoses were associated with reporting pain since treatment completion (compared with leukaemia; OR=4.27, 95%CI=1.21-15.02). Having received radiotherapy was associated with future anticipated fatigue (OR=3.68, 95%CI=1.56-7.34). Bone marrow transplants were associated with experiencing fatigue (OR=2.83, 95%CI=1.13-7.08) and anticipated future fatigue (OR=2.54, 95%CI=1.01-6.36). Survivors who reported pain, fatigue, anticipated future pain, and anticipated future fatigue had greater needs for information about managing these late effects. Additionally, 8.7% of participants reported ‘a lot’ or ‘a great deal’ of fear of cancer recurrence. Survivors with unmet needs for information about managing pain and fatigue reported higher fear of cancer recurrence than survivors with no reported need for information (B=0.48, 95%CI=0.19-0.76, p <.001). Long-term follow-up clinics should assess pain and fatigue, especially among survivors of bone and soft tissue sarcomas and recipients of bone marrow transplant. Information provision about pain and fatigue may be an important tool to help manage fear of cancer recurrence.