Is a new perspective for definition and diagnostic criteria of fibromyalgia in early stage cancer patients necessary? Ozgur Tanriverdi ⇑ Department of Medical Oncology, Faculty of Medicine, Mugla Sitki Kocman University, Mugla, Turkey article info Article history: Received 28 October 2013 Accepted 18 January 2014 abstract Fibromyalgia is a most common pain syndrome characterized by the presence of chronic widespread pain and tenderness with manual palpation. However there is no enough data about frequent of fibromyalgia syndrome in patients with cancer. How often FM is being used in oncological practice and how we are managing this case by medical oncologists. Widespread pain index and symptom severity scale are not clear enough in patients with cancer when ACR-2010 diagnostic criteria for FM are considered. In conclu- sion, there is it may more prevalence of fibromyalgia in patients with cancer. For the diagnosis of fibro- myalgia, be new diagnostic criteria for early-stage cancer patients. Ó 2014 Elsevier Ltd. All rights reserved. Background Cancer patients have a difficult process due to diagnosis, surgi- cal operations, chemotherapy, and radiation therapy [1]. In this process, psychological disorders are observed more than normal population [1–3]. In early-stage cancer patients, after the administered adjuvant chemotherapy (CT) and/or radiotherapy (RT) following the curative treatment are being followed up regularly with control visits. In this situation as well as to find symptoms and definitions for recurrence of cancer, symptoms and/or signs of the long-term che- motherapy or radiation therapy related adverse effect are investi- gated. Especially, it is clear that signs and symptoms of systemic diseases are very important cause for morbidity and mortality in cancer survivors. In addition, confusion of cancer recurrence and other psychological diseases’ symptoms cause anxiety, sequence of examination and to control symptoms consistently at patients and their oncologists [1]. Here is common and regional pain is a type of such symptoms [4–6]. When trying to explain cancer recur- rence in oncological practice, it may also an obscurity that how important psycho-oncological approach and fibromyalgia syn- drome (FM) and pain syndrome which is also observed in normal population are. FM is a not rarely situation characterized by the presence of chronic widespread pain and tenderness with light manual palpa- tion and is identified as a condition resulting in both chronic, wide- spread pain and a variety of somatic complaints [4]. FM occurs disproportionately among women and FM has been estimated to affect and it affects nearly 2–3% of adults in the European and American population [7]. FM is commonly regarded to be a stress-related symptoms due to its development following stressful conditions, which may include physical trauma, various environmental exposures, infec- tious diseases, or severe psychosocial force [7]. Common character- istics other than pain to look for are complaints of cognitive dysfunction, sensitivity to light or sound, functional bowel disor- ders, ocular complaints such as dry eyes or changing focus, and a history or clinical evidence of anxiety or affective disturbance [7,8]. There is no enough data about frequent of FM in patients with cancer. In a study, frequent of fibromyalgia syndrome in early stage breast cancer patients have been discussed and the frequent is notified as 9.9% (n = 10) [9,10]. Additionally, fibromyalgia impact questionnaire has been used in previous studies in hospitalized cancer patients and breast cancer patients, fibromyalgia was fre- quent in cancer patients than healthy population and life quality has affected negatively [11–13]. The important issue is how FM and diagnosis can be defined. In diagnostic criteria for FM, some points are not enough to diagnose and can be kept in the background by postoperative chronic symp- toms or radiotherapy dermatitis or CT-related neuropathy. So in patients with cancer before cancer or during follow up, for diagno- sis of common and regional pain which can be caused by 2010 cri- teria of FM by American College of Rheumatology (ACR) should be discussed [14,15] (Table 1). http://dx.doi.org/10.1016/j.mehy.2014.01.018 0306-9877/Ó 2014 Elsevier Ltd. All rights reserved. ⇑ Address: Mugla Universitesi Eg ˘itim ve Arastirma Hastanesi, Onkoloji Bolumu, 48000 Mugla, Turkey. Tel.: +90 252 214 13 26; fax: +90 252 212 68 04. E-mail address: mugla.medicaloncology@gmail.com Medical Hypotheses 82 (2014) 433–436 Contents lists available at ScienceDirect Medical Hypotheses journal homepage: www.elsevier.com/locate/mehy