Cancer pain

painbone cancer paincancerchemotherapy-induced peripheral neuropathydorsal root entry zone (DREZ) lesioningDorsal root entry zone lesioningPain managementpain relief
Pain in cancer may arise from a tumor compressing or infiltrating nearby body parts; from treatments and diagnostic procedures; or from skin, nerve and other changes caused by a hormone imbalance or immune response.wikipedia
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Pain management

pain medicinepain reliefpain control
Healthcare professionals have an ethical obligation to ensure that, whenever possible, the patient or patient's guardian is well-informed about the risks and benefits associated with their pain management options.
It was first described for use in cancer pain, but it can be used by medical professionals as a general principle when dealing with analgesia for any type of pain.

Chronic pain

chronicpainChronic pain syndrome
Most chronic (long-lasting) pain is caused by the illness and most acute (short-term) pain is caused by treatment or diagnostic procedures. Pain is classed as acute (short term) or chronic (long term).
Limited evidence suggests that chronic pain from tissue inflammation or damage (as in rheumatoid arthritis and cancer pain) is best treated with opioids, while for neuropathic pain (pain caused by a damaged or dysfunctional nervous system) other drugs may be more effective, such as tricyclic antidepressants, serotonin-norepinephrine reuptake inhibitors, and anticonvulsants.

Paracetamol

acetaminophenPanadolTylenol PM
The WHO guidelines recommend prompt oral administration of drugs when pain occurs, starting, if the person is not in severe pain, with non-opioid drugs such as paracetamol, dipyrone, non-steroidal anti-inflammatory drugs or COX-2 inhibitors.
Paracetamol is also used for severe pain, such as cancer pain and pain after surgery, in combination with opioid pain medication.

Pain

physical painacute painnociceptive pain
Pain is classed as acute (short term) or chronic (long term).
Pain is usually transitory, lasting only until the noxious stimulus is removed or the underlying damage or pathology has healed, but some painful conditions, such as rheumatoid arthritis, peripheral neuropathy, cancer and idiopathic pain, may persist for years.

Codeine

codeine phosphatecodeine hydrochlorideCod'ine
Then, if complete pain relief is not achieved or disease progression necessitates more aggressive treatment, mild opioids such as codeine, dextropropoxyphene, dihydrocodeine or tramadol are added to the existing non-opioid regime.
Weak evidence indicates that it is useful in cancer pain, but it is associated with increased side effects.

Fentanyl

ActiqDuragesicfentanyl citrate
Current evidence for the effectiveness of fentanyl transdermal patches in controlling chronic cancer pain is weak but they may reduce complaints of constipation compared with oral morphine.
It is also used in the management of chronic pain including cancer pain.

Route of administration

parenteralroutes of administrationparenterally
Other delivery routes such as sublingual, topical, transdermal, parenteral, rectal or spinal should be considered if the need is urgent, or in case of vomiting, impaired swallow, obstruction of the gastrointestinal tract, poor absorption or coma.

Esophageal cancer

throat canceroesophageal canceresophageal
Pain behind the breastbone or in the region around the stomach often feels like heartburn.

Pancreatic cancer

pancreaticpancreaspancreatic carcinoma
Palliative care focuses not on treating the underlying cancer, but on treating symptoms such as pain or nausea, and can assist in decision-making, including when or if hospice care will be beneficial.

Radiation therapy

radiotherapyradiation oncologyradiation
However, radiotherapy, surgery and chemotherapy may produce painful conditions that persist long after treatment has ended.

Chemotherapy

chemotherapeuticantineoplasticantineoplastic agent
However, radiotherapy, surgery and chemotherapy may produce painful conditions that persist long after treatment has ended.

Cancer staging

stagestagingstage IV
The presence of pain depends mainly on the location of the cancer and the stage of the disease.

Malignancy

malignantmalignanciesmalignant cells
At any given time, about half of all people diagnosed with malignant cancer are experiencing pain, and two thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living.

Cancer

cancersmalignanciescancerous
At any given time, about half of all people diagnosed with malignant cancer are experiencing pain, and two thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living.

Activities of daily living

daily livinginstrumental activities of daily livingADLs
At any given time, about half of all people diagnosed with malignant cancer are experiencing pain, and two thirds of those with advanced cancer experience pain of such intensity that it adversely affects their sleep, mood, social relations and activities of daily living.

Pain management in children

Cancer pain in childrenfeel painpain in infants
Cancer pain in children is also reported as being under-treated.

World Health Organization

WHOWorld Health OrganisationWorld Health Organization (WHO)
Guidelines for the use of drugs in the management of cancer pain have been published by the World Health Organization (WHO) and others.

Depression (mood)

depressiondepressedmelancholy
Pain is also associated with increased depression, anxiety, fear, and anger.

Psychosurgery

psychosurgicalprefrontal lobotomypsycho surgery
For example, it is possible through psychosurgery and some drug treatments, or by suggestion (as in hypnosis and placebo), to reduce or eliminate the unpleasantness of pain without affecting its intensity.

Hypnosis

hypnotismhypnotisthypnotic
For example, it is possible through psychosurgery and some drug treatments, or by suggestion (as in hypnosis and placebo), to reduce or eliminate the unpleasantness of pain without affecting its intensity.

Placebo

placebo effectplacebosplacebo studies
For example, it is possible through psychosurgery and some drug treatments, or by suggestion (as in hypnosis and placebo), to reduce or eliminate the unpleasantness of pain without affecting its intensity.

Referred pain

referredfeltpain
This is called referred pain.

Nociception

nociceptiveantinociceptivepain perception
Pain in cancer can be produced by mechanical (e.g. pinching) or chemical (e.g. inflammation) stimulation of specialized pain-signalling nerve endings found in most parts of the body (called nociceptive pain), or it may be caused by diseased, damaged or compressed nerves, in which case it is called neuropathic pain.

Neuropathic pain

neuropathicpaincentral neuropathic pain
Pain in cancer can be produced by mechanical (e.g. pinching) or chemical (e.g. inflammation) stimulation of specialized pain-signalling nerve endings found in most parts of the body (called nociceptive pain), or it may be caused by diseased, damaged or compressed nerves, in which case it is called neuropathic pain.

Paresthesia

paraesthesiatinglingparesthesias
Neuropathic pain is often accompanied by other feelings such as pins and needles.