A systematic review of orofacial pain in patients receiving cancer therapy

Abstract

This systematic review identified the presence of pain before cancer therapy, likely attributable to the cancer; an increase in pain during therapy and the common persistence of pain following cancer treatment. Continuing research should use validated tools to prospectively assess orofacial pain, its causes and pathophysiology, and its effect on quality of life and economic impact. Clinical trials of pain management in this setting are also warranted.

Experiences of Pain: A Longitudinal, Qualitative Study of Patients with Head and Neck Cancer Recently Treated with Radiotherapy

“…The results agree with several studies reporting function-related mucositis pain, tumor pain, and breakthrough pain as very common in cancer patients (Bhatnagar, et al, 2010;Epstein, et al, 2010;Pauloski, et al, 2011). In two studies, as in ours, this pain was clearly and primarily linked to RT-induced mucositis (Cheng & Lee, 2011;Rose-Ped, et al, 2002).…”

“…The overall five-year survival rate varies between 23% and 88% depending on the type of HNC (Argiris, et al, 2008). Prevalence of pain in is common and about 80 % reports of pain during cancer therapy (Epstein, et al, 2010).…”

Predictors of Long-Term Opioid Treatment Among Patients Who Receive Chemoradiation for Head and Neck Cancer

“…Pain control in more than half of these patients is achieved with opioids [5,6], the mainstay of analgesia in managing moderate to severe pain related to cancer and its treatments. Approximately one third of patients reported persistent orofacial pain even months after treatment [7][8][9]. Persistent pain requiring opioids in cancer survivors without evidence of disease may be related to chronic tissue damage from cancer or its treat-ments, comorbidities such as periodontal disease, psychological factors, or opioid dependency/abuse [10,11].…”

Oral cancer associated orofacial pain: An overview

“…Interestingly, both small-diameter sensory fibers, unmyelinated C fibers and thinly myelinated A-delta fibers and large myelinated A-beta fibers are affected by chemotherapeutic agents, with the large fibers being preferentially injured by CT agents such as vinca alkaloids, taxanes, and platinum-based compounds. [3] RT plays an important role in the management of HNC. The early or acute effects depend on the radiated fields and include skin/mucosal reactions, nausea, diarrhea, and neutropenia and are usually self-limiting.…”

“…One routine clinical approach to pain assessment and management is summarized by the mnemonic "ABCDE": [3,6] A -Ask about pain regularly. Assess pain systematically B -Believe the patient and family in their reports of pain and what relieves it C -Choose pain control options appropriate for the patient, family, and setting D -Deliver interventions in a timely, logical, and coordinated fashion E -Empower patients and their families.…”