Qualitative analysis of pain in patients with locally advanced or metastatic urothelial carcinoma

Abstract

BACKGROUND: Pain is not well described in patients with locally advanced or metastatic urothelial cancer (la/mUC).OBJECTIVE: To characterize pain and assess the content validity of the Brief Pain Inventory Short Form (BPI-SF) worst pain item in patients with la/mUC receiving first-line treatment in the US.METHODS: Qualitative interviews were conducted in patients aged >= 45 years with confirmed la/mUC, self-reported la/mUC-attributed pain before enrollment, and no major surgery <= 3 months prior to being interviewed. Interview participants were asked open-ended questions about their la/mUC symptoms and pain. "Think aloud" cognitive debriefing was conducted for the BPI-SF worst pain item.RESULTS: Ten participants with laUC and six (38%) with mUC were interviewed. First-line treatments included cisplatin (n=14; 88%) or carboplatin (n= 2; 13%). The average past-week worst pain score (0-10 scale) was 6.2 (range, 3-10); seven (44%) participants reported severe pain (score >= 7). Pain was most frequently reported in the back (n=14; 88%) and/or pelvic/lower abdominal area (n=10; 63%). Pain impacted all participants' physical and daily activities; 81% reported it impacted their overall quality of life. All participants interpreted and completed the BPI-SF worst pain item without difficulty; 15 (94%) reported it was relevant to their la/mUC experience. Participants understood the 24-hour recall period; most supported daily (n= 13; 81%) or weekly (n=14; 88%) assessment, preferring electronic administration using their phone (n= 14; 88%).CONCLUSIONS: Pain attributed to la/mUC impacted physical and daily activities in all participants undergoing first-line treatment for la/mUC. Content validity was demonstrated for the BPI-SF worst pain item in this population.