Update in Cancer Pain Syndromes

Abstract

Cancer pain assessment and management are integral to palliative medicine. This paper reviews recent publications in the period 1999-2004 in the broad categories of epidemiology, pain assessment, nonpharmacologic approaches to cancer pain (radiation therapy, anesthetic blocks, palliative surgery and chemotherapy, complementary and alternative medicine), and in nociceptive pain, neuropathic pain, visceral pain, and bone pain.

Post hoc analysis of pregabalin vs. non-pregabalin treatment in patients with cancer-related neuropathic pain: better pain relief, sleep and physical health

“…32%-39.7% of cancer pain has a neuropathic component [2,3], mostly mixed with a nociceptive component. The most frequent causes of NP cancer pain are nervous injury or compression by tumour growth and infi ltration, and sympathetically maintained pain secondary to oncologic treatment [4,5].…”

Oncology Pain and Complementary Therapy

“…Pain can be focal, multifocal, or generalized, with patients often experiencing deep powerful throbbing disrupted by sharper intense pain (Chang, Janjan, Jain, & Chau, 2006;Shaiova, 2006). The pain usually is associated with invasion of the tumor into the bone, often causing debilitation that is worsened by movement or weightbearing activities (Chang et al, 2006;Shaiova, 2006 Note. Based on information from Chang et al, 2006;Lee & Washington, 2008;Miller et al, 2001;Shaiova, 2006. common tumors that metastasize to bone originate in the breast, lung, prostate, thyroid, and kidney (Shaiova, 2006).…”

Managing skeletal related events resulting from bone metastases

“…Usually more than half of the bone must be involved for a lesion to be visible on plain radiography ( fig 1⇓). 7 The low sensitivity and specificity (46% and 32% respectively) 8 of radiography necessitates continued investigation if bone metastases are strongly suspected.…”

“…Computed tomography with bone windows or magnetic resonance imaging can be useful in locating such fractures when they do not show up on plain x ray films ( fig 3⇓). 7 Magnetic resonance imaging of axial skeleton is seen as the ideal imaging technique for detecting metastases, and it has a sensitivity of 100% and a specificity of 88%. 8…”