Body-Wide Pain May Signal
Risk of Cancer Death
Excerpt By Amy Norton, Reuters Health

NEW YORK (Reuters Health) - Having pain throughout the body even occasionally may indicate higher-than-average odds of dying from cancer, a UK study suggests.

The study of nearly 6,600 adults in England looked at whether having at least one day of pain in the previous month was linked to death risk over the next 8 years. Researchers found that those who reported widespread bodily pain were twice as likely as pain-free respondents to die from cancer.

Dr. Gary J. Macfarlane and colleagues at the University of Manchester, UK, surveyed 6,569 people aged 18 to 85. They then followed death rates and causes of death in the group over 8 years. Their findings are published in the September 22nd issue of the British Medical Journal.

The investigators found that those who reported widespread bodily pain at the beginning of the study were twice as likely as those who reported no pain to die from cancer. And those who reported at least one day's worth of pain in only part of the body were 55% more likely than the pain-free to die from cancer.

This link between pain and cancer death remained even after Macfarlane's team accounted for participants' age, smoking habits and levels of ``psychological distress.''

But what the link means is uncertain, according to the researchers. And, they stress, ``it is important to set the risk in context: the vast majority of such people (with widespread pain) did not die from cancer.''

Just over 1,000 respondents, or 15%, reported widespread pain. One in 20 died from cancer, the report indicates.

``Although (people) with widespread pain were twice as likely to die from cancer when compared to those with no pain, the increase in numbers of deaths from cancer was relatively small,'' study co-author Dr. John McBeth told Reuters Health.

The researchers did not ask participants about the possible source of their pain, but McBeth said that in cases of widespread pain, the cause usually remains a mystery.

As for a cause of the relationship between pain and cancer death, he and his colleagues speculate that some of the same contributing factors underlie both cancer risk and body-wide pain--including stressful life events and emotional problems. Or, they suggest, a tendency to suffer widespread pain may shorten a person's survival after developing cancer.

In an accompanying editorial, Dr. Iain K. Crombie of the University of Dundee in the UK says the new finding ``needs to be taken seriously,'' but also requires ``careful review.''

``Are the findings plausible, what other explanation could there be, and what should be done next?'' Crombie writes.

A possible explanation for the link, he notes, is that the pain these people had was an early symptom of as-yet-undiagnosed cancer.

``The answer,'' Crombie concludes, ``will require further research.''

SOURCE: British Medical Journal 2001;323:662-665.

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