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. 2018 Jul;56(1):88-97.
doi: 10.1016/j.jpainsymman.2018.02.021. Epub 2018 Mar 7.

Associations Between Perceived Stress and Chemotherapy-Induced Peripheral Neuropathy and Otoxicity in Adult Cancer Survivors

Christine Miaskowski  1 , Steven M Paul  2 , Judy Mastick  2 , Gary Abrams  3 , Kimberly Topp  3 , Betty Smoot  3 , Kord M Kober  2 , Margaret Chesney  3 , Melissa Mazor  2 , Grace Mausisa  2 , Mark Schumacher  3 , Yvette P Conley  4 , Jennifer Henderson Sabes  3 , Steven Cheung  3 , Margaret Wallhagen  2 , Jon D Levine  5
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Associations Between Perceived Stress and Chemotherapy-Induced Peripheral Neuropathy and Otoxicity in Adult Cancer Survivors

Christine Miaskowski et al. J Pain Symptom Manage. 2018 Jul.

Abstract

Context: The most common adverse effects from neurotoxic chemotherapy are chemotherapy-induced neuropathy (CIPN), hearing loss, and tinnitus. Although associations between perceived stress and persistent pain, hearing loss, and tinnitus are documented, no studies have examined these associations in cancer survivors who received neurotoxic chemotherapy.

Objectives: In this cross-sectional study, we evaluated for associations between perceived stress and the occurrence of CIPN, hearing loss, and tinnitus, in 623 adult cancer survivors who received platinum and/or taxane compounds.

Methods: Survivors completed self-report measures of hearing loss, tinnitus, and perceived stress (i.e., Impact of Events Scale-Revised [IES-R]). Separate logistic regression analyses were done for each neurotoxicity to evaluate whether each of the IES-R subscale (i.e., intrusion, avoidance, hyperarousal) and total scores made a significant independent contribution to neurotoxicity group membership.

Results: Of the 623 survivors in this study, 68.4% had CIPN, 34.5% reported hearing loss, and 31.0% reported tinnitus. Older age, higher body mass index, poorer functional status, being born prematurely, cancer diagnosis, and higher intrusion (P = 0.013), hyperarousal (P = 0.014), and total (P = 0.047) IES-R scores were associated with CIPN. Older age, being male, poorer functional status, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.007) score were associated with hearing loss. Being male, having less education, a worse comorbidity profile, and a higher IES-R hyperarousal (P = 0.029) score were associated with tinnitus.

Conclusion: These findings suggest that increased levels of perceived stress are associated with the most common chemotherapy-induced neurotoxicities.

Keywords: Stress; cancer survivor; chemotherapy; hearing loss; peripheral neuropathy; tinnitus.

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Conflict of interest statement

Conflict of interest: The authors have no conflict of interests to declare.

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References

    1. Fink G. Stress, Definitions, Mechanisms, and Effects Outlined: Lessons from Anxiety. In: Fink G, editor. Stress: Concepts, Cognition, Emotion, and Behavior. London, England: Elsevier; 2016. pp. 3–11.
    1. McEwen BS, Gray JD, Nasca C. 60 YEARS OF NEUROENDOCRINOLOGY: Redefining neuroendocrinology: stress, sex and cognitive and emotional regulation. J Endocrinol. 2015;226:T67–83. - PMC - PubMed
    1. Chapman CR, Tuckett RP, Song CW. Pain and stress in a systems perspective: reciprocal neural, endocrine, and immune interactions. J Pain. 2008;9:122–145. - PMC - PubMed
    1. Dean J, Keshavan M. The neurobiology of depression: An integrated view. Asian J Psychiatr. 2017;27:101–111. - PubMed
    1. Kim YK, Won E. The influence of stress on neuroinflammation and alterations in brain structure and function in major depressive disorder. Behav Brain Res. 2017;329:6–11. - PubMed

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