Physical function and pain intensity in patients with metastatic bone disease

J Surg Oncol. 2019 Sep;120(3):376-381. doi: 10.1002/jso.25510. Epub 2019 May 29.


Background: Patient reported outcome data in bone metastatic disease are scarce and it would be useful to have normative data and understand what patients are at risk for poor function and more pain.

Objectives: We aimed to assess what factors are independently associated with physical function and pain intensity in patients with bone metastasis.

Methods: We included data from 211 patients with bone metastasis who completed a survey (2014-2016) including the PROMIS Physical Function Cancer and PROMIS Pain Intensity questionnaires.

Results: Prostate (P < .001) and thyroid carcinoma (P = .007) were associated with better function and having other disabling conditions (P = 0.035) was associated with worse function. Prostate carcinoma (P = .001) and lymphoma (P = .007) were associated with less pain. There was a moderate correlation between pain and function (P < .001). Function was substantially worse as compared to a US reference population of patients with cancer (P < .001), whereas pain was slightly less compared to the US general population average (P < .001).

Conclusions: Patients with bone metastasis have a poor physical function. Physical function and pain intensity depend on tumor histology, but also on potentially modifiable factors such as other disabling conditions.

Level of evidence: Level III, prognostic study.

Keywords: PROMIS; bone metastases; cancer; pain; physical function.

MeSH terms

  • Bone Neoplasms / physiopathology*
  • Bone Neoplasms / secondary*
  • Cancer Pain / etiology*
  • Cancer Pain / physiopathology*
  • Case-Control Studies
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Neoplasms / pathology
  • Neoplasms / physiopathology
  • Prostatic Neoplasms / pathology
  • Prostatic Neoplasms / physiopathology
  • Thyroid Neoplasms / pathology
  • Thyroid Neoplasms / physiopathology