Pain and Cognitive Concerns Among Breast Cancer Survivors: The Mediating Role of Substance Use Coping

Context

Bodily pain and cognitive concerns are both prevalent and share similar underlying mechanisms. A few studies have suggested that pain and cognitive concerns may be linked through substance use coping; however, this relationship remains unclear, particularly among breast cancer survivors (BCS). Gaining a clearer understanding of this relationship is critical, as it could inform survivorship care plans for BCS.

Objectives

This study aims to investigate whether bodily pain is related to cognitive concerns among BCS and to further explore whether this relationship is mediated by substance use coping.

Methods

This study is a sub-analysis of data obtained from a larger cross-sectional study. Bodily pain was assessed using the Short-Form Health Survey, and cognitive concerns were measured using the Patient-Reported Outcomes Measurement Information System. Substance use coping was assessed using two items from the Brief Coping Orientation to Problems Experienced Inventory. Path analysis was used to examine the relationships among bodily pain, substance use coping, and cognitive concerns.

Results

Higher levels of bodily pain and higher use of substance use coping were associated with greater cognitive concerns. Although the relationship was weakly related, we found that bodily pain was associated with substance use coping, and that substance use coping mediated the association between bodily pain and cognitive concerns.

Conclusion

These findings highlight the importance of regular pain assessments to help prevent future behavioral and cognitive consequences. Moreover, efforts to screen for and manage both pain and substance use may ultimately help prevent cognitive problems during survivorship.