Pain after cancer: Time to move towards a mechanism‐based approach!

Abstract

The high prevalence and the debilitating nature of pain following cancer urge the need for appropriate pain assessment and management in this population. Yet cancer pain remains under‐recognized and under‐treated. For effective pain management, correct identification of the presence of different underlying pain mechanisms is warranted, since pain management strategies differ considerably according to the predominant mechanisms. To raise awareness around possible underlying pain mechanisms in pain after cancer, the three major pain mechanisms are shortly explained and translated to this specific population. Next, in this Special Issue, we delve further into the existing evidence on the presence of these pain mechanisms in patients with pain after cancer, and on how they can be assessed or approached in patients with pain after cancer.

Targeting TRPV4 Channels for Cancer Pain Relief

“…The transition from a symptom-based approach to a more mechanistic-based classification is relatively recent. This considers the differential classification, well-defined by the International Association for the Study of Pain (IASP) as nociceptive, neuropathic, and nociplastic pain, which is extensively used in pain research [4,49,51].…”

“…Because of the poor understanding of the mechanisms involved in its etiology, cancer pain remains under-investigated, and in addition to the lack of selective targets for developing novel, effective, and safe drugs, its management is often suboptimal, with patients undergoing unsatisfactory treatments [4,54]. Due to their central involvement as mediators in the mechanisms of painful stimulus transmission between the central and peripheral nervous system, sensory afferent fibers are attractive candidates to alleviate this symptom.…”

“…However, the mortality rates have been declining in recent years because of the effectiveness of novel therapies developed for cancer treatment. This increase in oncological patient survival also means that more patients are likely to live with long-lasting symptoms arising or persisting beyond the conclusion of therapy [4]. A significant proportion of survivors are affected by complications and sequelae, such as chronic pain, a secondary symptom linked to the underlying disease [5].…”