Abstract
Cancer pain is a subjective sensation of tissue damage, which has an adverse influence on multiple domains in an individual’s life. Severe pain is associated with decreased function, increased interference with daily activities, depression, and anxiety. Pain is a major problem in 25–30% of individuals with newly diagnosed cancer and 70–80% with advanced cancer. Over 500,000 Americans die of cancer each year corresponding to 1,500 deaths per day [1]; therefore, cancer pain is a major problem that cancer specialists face. The lifetime probability of invasive cancer is 45% for men and 38% for women. Among men, prostate, lung, colon, and rectal cancers account for 50% of newly diagnosed cancers. Breast, lung, and colorectal cancers account for 50% of cancers in women. [1] As a result, bone and visceral pain are major pain subtypes clinicians need to manage.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Jemal A, Siegel R, Ward E, et al. Cancer Statistics, 2008. CA Cancer J Clin 2008, 58:71–96.
Caraceni A, Portenoy RK, a working group of the IASP Task Force on Cancer Pain. An International survey of cancer pain characteristics and syndromes. Pain 1999, 82:263–74.
Soderlund V. Radiological diagnosis of skeletal metastases. Eur Radiol 1996, 6:587–95.
Turk DC. Remember distinction between malignant and benign pain? Well forget it. Clin J Pain 2002, 18(2):75–6.
Dickenson AH, Bee LA, Suzuki R. Pains, gains, and midbrains. Proc Natl Acad Sci USA 2005, 102(50):17885–6.
Iannetti GD, Zambreanu L, Wise RG, et al. Pharmacological modulation of pain-related brain activity during normal and central sensitization states in humans. Proc Natl Acad Sci USA 2005, 102(50):18195–200.
Liebeskind JC. Pain can kill. Pain 1991, 44(1):3–4.
Harvey VL, Dickenson AH. Mechanisms of pain in nonmalignant disease. Curr Opin Support Palliat Care 2008, 2:133–9.
D’Mello R, Dickenson AH. Spinal cord mechanisms of pain. Br J Anaesth 2008, 101:8–16.
Aurilio C, Pota V, Pace AC, et al. Ionic channels and neuropathic pain: physiopathology and applications. J Cell Physiol 2007, 215:8–14.
Rogers M, Tang L, Madge DJ, et al. The role of sodium channels in neuropathic pain. Semin Cell Dev Biol 2006, 17:571–81.
Luger NM, Mach DB, Sevcik MA, et al. Bone cancer pain: from model to mechanism to therapy. J Pain Symptom Manage 2005, 29(5S):S32–46.
Honore P, Rogers SD, Schwel MJ, et al. Murine models of inflammatory, neuropathic and cancer pain each generates a unique set of neurochemical changes in the spinal cord and sensory neurons. Neuroscience 2000, 98(3):585–9.
Luger NM, Sabino MC, Schwei MJ, et al. Efficacy of systemic morphine suggests a fundamental difference in the mechanisms that generate bone cancer vs inflammatory pain. Pain 2002, 99(3):397–406.
Caraceni A, Zecca E, Martini C, et al. Gabapentin for breakthrough pain due to bone metastases. Palliat Med 2008, 22:392–3.
Regan JM, Peng P, Chan VWS. Neurophysiology of cancer pain: from the laboratory to the clinic. Curr Rev Pain 1999, 3:214–25.
Burian M, Geisslinger G. COX-dependent mechanisms involved in the antinociceptive action of NSAIDs at center and peripheral sites. Pharmacol Ther 2005, 107:139–54.
McCormack K. The spinal actions of nonsteroidal anti-inflammatory drugs and the dissociation between their anti-inflammatory and analgesic effects. Drugs 1994, 47(5):28–45.
Leith JL, Wilson AW, Donaldson LF, et al. Cyclooxygenase-1-derived prostaglandins in the periaqueductal gray differentially controls C-versus A-fiber-evoked spinal nociception. J Neurosci 2007, 27(42):11296–305.
Murakami M, Kudo I. Prostaglandin E synthase: a novel drug target for inflammation and cancer. Curr Pharm Des 2006, 12:943–54.
Melzack R, Wall PD. Pain mechanisms. Science 1965, 150(699):971–9.
Pasternak GW. Molecular biology of opioid analgesia. J Pain Symptom Manage 2005, 29(5S):S2–9.
Trescot AM, Datta S, Lee M, et al. Opioid pharmacology. Pain Physician 2008, 11:S133–53.
Law PY, Loh HH. Regulation of opioid receptor activities. J Pharmacol Exp Ther 1999, 289:607–24.
Snyder SH. Opioid receptor revisited. Anesthesiology 2007, 107:659–61.
Garzon J, Rodriguez-Munoz M, Sanchez-Blazquez P. Do pharmaceutical approaches that prevent opioid tolerance target different elements in the same regulatory machinery? Curr Drug Abuse Rev 2008, 1:222–38.
Pelissier T, Laurido C, Kramer V, et al. Antinociceptive interactions of ketamine with morphine or methadone in mononeuropathic rats. Eur J Pharmacol 2003, 477:23–28.
Hermstad MJ, Gibbins J, Caraceni A, et al. Pain assessment tools in palliative care: an urgent need for consensus. Palliat Med 2008, 22:895–903.
Davis MP, Weissman DE, Arnold RM. Opioid dose titration for severe cancer pain: a systematic evidence-based review. J Palliat Med 2004, 7(3):462–8.
Walsh D, Rivera NI, Davis MP, et al. Strategies for pain management: Cleveland Clinic Foundation guidelines for opioid dosing for cancer pain. Support Cancer Ther 2004, 1(3):157–64.
Anderson KO. Assessment tools for the evaluation of pain in the oncology patient. Curr Pain Headache Rep 2007, 11:259–64.
Jensen MP, Dworkin RH, Gammaitoni AR, et al. Do pain qualities and spatial characteristics make independent contributions to interference with physical and emotional functioning? J Pain 2006, 7(9):644–53.
Caraceni A, Cherny N, Fainsinger R, et al. Pain measurement tools and methods in clinical research in palliative care: recommendations of an expert working group of the European Association of Palliative Care. J Pain Symptom Manage 2002, 23(3):239–55.
Radbruch L, Sabatowski R, Loick G, et al. Cognitive impairment and its influence on pain and symptom assessment in a palliative care unit: development of a minimal documentation system. Palliat Med 2000, 14:266–76.
Twycross R, Harcourt J, Bergl S. A survey of pain in patients with advanced cancer. J Pain Symptom Manage 1996, 12(5):273–82.
Farrar JT, Berlin JA, Strom BL. Clinically important changes in acute pain outcome measures: a validation study. J Pain Symptom Manage 2003, 25(5):406–11.
Turk DC, Dworkin RH, McDermott MP, et al. Analyzing multiple endpoints in clinical trials of pain treatments: IMMPACT recommendations. Pain 2008, 139:485–93.
Dworkin RH, Turk DC, Wyrwich KW, et al. Interpreting the clinical importance of treatment outcomes in chronic pain clinical trials: IMMPACT recommendations. J Pain 2008, 9(2):105–121.
Rosenthal DI. Radiological diagnosis of bone metastases. Cancer 1997, 80:1595–607.
White AP, Kwon BK, Linskog DM, et al. Metastatic disease of the spine. J Am Acad Orthop Surg 2006, 14:587–8.
Mahfouz AE, Hamm B, Mathieu D. Imaging of metastases to the liver. Eur Radiol 1996, 6:607–14.
Pfister DG, Johnson DH, Azzoli C, et al. American Society of Clinical Oncology treatment of nonresectable non-small-cell lung cancer guidelines: update 2003. J Clin Oncol 2004, 22(2):330–53.
Gould MK, Kuschner WG, Rydzak CE, et al. Test performance of positron emission tomography and computed tomography for mediastinal staging in patients with non-small-cell lung cancer: a meta-analysis. Ann Intern Med 2003, 139(11):879–92.
Silvestri GA, Gould MK, Margolis ML, et al. Noninvasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007, 132(3 Suppl):178S–201
Fallon M, Hanks G, Cherny N. Principles of cancer pain. BMJ 2006, 332:1022–4.
Hanks GW, de Conno F, Cherny N, et al. Morphine and alternative opioids in cancer pain: the EAPC recommendations. Br J Cancer 2001, 84(5):587–93.
Jost L. Management of cancer pain: ESMO clinical recommendations. Ann Oncol 2007, 18:92–94.
Krakowski I, Theobald S, Balp L, et al. Summary version of the standards, options and recommendations for the use of analgesia for the treatment of nociceptive pain in adults with cancer (update 2002). Br J Cancer 2003, 89(Suppl 1):S67–72.
Mercandante S. Opioid rotation for cancer pain. Rationale and clinical aspects. Cancer 1999:86:1856–66.
Gralow I. Cancer pain: an update of pharmacological approaches in pain therapy. Curr Opin Anaesthesiol 2002, 15:555–61.
Davis MP, Lasheen W, Gamier P. Practical guide to opioids and their complications in managing cancer pain. What oncologists need to know. Oncology 2007, 21(10):1229–38.
Hagen NA, Biondo P, Stiles C. Assessment and management of breakthrough pain in cancer patients: current approaches and emerging research. Curr Pain Headache Rep 2008, 12:241–8.
Carr DB, Goudas LC, Balk EM, et al. Evidence report on the treatment of pain in cancer patients. Evidence report on the treatment of pain in cancer patients. J Natl Cancer Inst Monogr 2004, 32:23–31.
Newsome S, Frawley BK, Argoff CE. Intrathecal analgesia for refractory cancer pain. Curr Pain Headache Rep 2008, 12:249–56.
Shaheen PE, Walsh D, Lasheen W, et al. Opioid equianalgesic tables: are they all equally dangerous? J Pain Symptom Manage 2009, 38(3):409–17.
Knotkova H, Fine PG, Portenoy RK. Opioid rotation: the science and limitations of the equianalgesic dose table. J Pain Symptom Manage 2009, 38(3):426–39.
Miller L, Shaw JS, Whiting EM. The contribution of intrinsic activity to the action of opioids in vitro. Br J Pharmac 1986, 87:595–601.
Grass JA. Patient-controlled analgesia. Anesth Analg 2005, 101:S44–61.
Davis MP. Patient-controlled analgesia chapter 24. Opioids in Cancer Pain, Oxford University Press, (Oxford UK) 2009, 367–84.
Elia N, Lysakowski C, Tramer MR. Does multimodal analgesia with acetaminophen, nonsteroidal anti-inflammatory drugs, or selective cyclooxygenase-2 inhibitors and patient-controlled analgesia morphine offer advantages over morphine alone? Anesthesiology 2005, 103:1296–304.
Marret E, Kurdi O, Zufferey P, et al. Effects of nonsteroidal anti-inflammatory drugs on patient-controlled analgesia morphine side effects. Anesthesiology 2005, 102:1249–60.
Grond S, Radbruch L, Lehmann KA. Clinical pharmacokinetics of transdermal opioids. Clin Pharmacokinet 2000, 38(1):59–89.
Pharo GH, Zhou L. Controlling cancer pain with pharmacotherapy. J Am Osteopath Assoc 2007, 107(Suppl 7):ES22–32.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2010 Society for Imaging Informatics in Medicine
About this chapter
Cite this chapter
Davis, M.P. (2010). Cancer Pain. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Boston, MA. https://doi.org/10.1007/978-1-4419-1225-1_2
Download citation
DOI: https://doi.org/10.1007/978-1-4419-1225-1_2
Published:
Publisher Name: Springer, Boston, MA
Print ISBN: 978-1-4419-1224-4
Online ISBN: 978-1-4419-1225-1
eBook Packages: MedicineMedicine (R0)