Psychological consequences of ineff ective pain management in patients with gynecologic cancer
Affiliation and adress for correspondence
A Team of Psychologists, Gynecology and Obstetrics Clinical Hospital of the Poznan University of Medical Sciences, Poznań, Poland
Correspondence: Jadwiga Łuczak-Wawrzyniak, A Team of Psychologists, Gynecology and Obstetrics Clinical Hospital of the Poznan University of Medical Sciences, Polna 33, 60-535 Poznań, Poland, tel.: +48 61 841 97 17, e-mail: jluczakwawrzyniak@gmail.com
Curr Gynecol Oncol 2018, 16 (2), p. 113–125
DOI: 10.15557/CGO.2018.0015
ABSTRACT

The paper presents selected views on pain as an experience and as a phenomenon as well as an analysis of factors reducing the efficacy of pain management in women with gynecologic cancer. Pain is an inseparable, natural and necessary element of life, which is primarily involved in responding to threat, but also accompanies effort, overcoming of which brings a number of psychosocial benefits. The subjective experience of pain depends on several factors, such as stimulant intensity, individual susceptibility and resistance to pain, or individual mental predispositions. In addition to appropriate pharmacotherapy, the efficacy of pain management in patients with gynecologic malignancies is further affected by mental disorders (cognitive, anxiety and depressive disorders), fixed, subjective ideas about the disease and its treatment (coined as nocebo by Walter Kennedy), multiple comorbidities, memory of pain, contact with the doctor, respecting patient’s rights by medical staff, age, and the quality of support received by the patient. The paper takes a critical look at replacing proven analgesic treatment strategies based on scientific and clinical evidence with unconventional methods, such as yoga, reiki or bioenergy therapy, which have not been verified or documented.

Keywords: gynecologic cancer, pain, mental state, nocebo effect