Regional Cancer Pain Syndromes

Abstract

Cancer pain often presents in a body region. This review summarizes articles from 1999-2004 relevant to cancer pain syndromes in the head and neck, chest, back, abdomen, pelvis, and limbs. Although the evidence is limited, progress is being made in further development of the evidence base to support and guide current practice.

Diltiazem for the Management of Malignancy-Associated Perineal Pain and Tenesmus

“…5,7 Such symptoms can be quite difficult to manage despite utilization of currently available therapies including oral analgesics, radiation and interventional techniques. 3,4,8 CCBs are a chemically diverse group of medications, most well known for their cardiovascular benefits. 9,10 They are also beneficial in the treatment of noncardiovascular diseases such as Raynaud's, migraine, pulmonary hypertension, and esophageal spasm.…”

Cancer Pain Management: Comprehensive Assessment and Nonopioid Analgesics, Part 1

“…For example, aching or gnawing right shoulder pain may be referred from hepatomegaly; left back pain may arise from a pancreatic tumor; and diffuse abdominal pain may be caused by omental inflammation, bowel or duct obstruction, hollow viscera stretching, or ascites, ischemia, or hepatomegaly (Shaiova, 2006). About 13% of patients with spinal metastases have radicular pain along affected dermatomes of distorted or compressed nerve roots, and some have accompanying motor or sensory deficits and hyperreflexia (Chang, Janian, Jain, & Chau, 2006). Thus, a metastatic deposit in the right side of the lumbar one vertebra (L1) could cause waist-level back pain ra-diating to the right hip and groin.…”

“…elicits details about pain quality that may aid analgesic selection (Table 1). Patients often use more than one quality word, reflecting different pain mechanisms (nociceptive or neuropathic) and analgesic choices (Chang et al, 2006;Dworkin, Jensen, Gammaitoni, Olaleye, & Galer, 2007;Holtan & Kongsgaard, 2009;Mackey et al, 2012;Pasternak, 2014). Visceral pain might be accompanied by nausea and vomiting, anorexia, bloating, and diaphoresis (Matthie & McMillan, 2014;Shaiova, 2006).…”

Myofascial pain syndrome after head and neck cancer treatment: Prevalence, risk factors, and influence on quality of life

“…In a systematic literature review of painful cancer syndromes, a high myofascial pain syndrome prevalence could be found among regional pain syndromes, often characterized by continuous localized pain or a cramping sensation and sometimes related to surgical trauma . Chaplin et al found that myofascial pain syndrome was observed in 13% of patients with head and neck cancer, whereas the myofascial pain diagnosis was given by the presence of painful muscles with tender spots on palpation or painful trigger points with muscle involvement.…”