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Neuromuscular Medicine: Cancer Pain

  • Eric Leung
Chapter

Abstract

Neuromuscular dysfunction in cancer is well recognized and is a major cause of pain and disability in this population. Injury of any segment of the neuromuscular system can lead to dysfunction and pain. Identification and characterization of the pain pattern and localization is crucial for diagnosis; however, symptoms may vary in presentation. Electrodiagnostic tools, such as nerve conduction studies (NCS) and needle electromyography (EMG), are used to differentiate and localize suspected injury to the neuromuscular system such as in radiculopathy, plexopathy, mononeuropathy, and peripheral neuropathy. There is limited evidence on the efficacy of the treatment options for neuromuscular dysfunction in the cancer patient. Treatment may be challenging, and an interdisciplinary and multimodal program is recommended.

Keywords

Neuromuscular medicine Electrodiagnosis Nerve conduction studies Electromyography Plexopathy Peripheral neuropathy Radiculopathy 

References

  1. 1.
    Swarm RA, Abernethy AP, Anghelescu DL, et al. Adult cancer pain. J Natl Compr Cancer Netw. 2013;11(8):992–1022.CrossRefGoogle Scholar
  2. 2.
    Denlinger CS, Ligibel JA, Are M, et al. Survivorship: pain version 1.2014. J Natl Compr Cancer Netw. 2014;12(4):488–500.CrossRefGoogle Scholar
  3. 3.
    Pachman DR, Barton DL, Swetz KM, Loprinzi CL. Troublesome symptoms in cancer survivors: fatigue, insomnia, neuropathy, and pain. J Clin Oncol. 2012;30(30):3687–96.CrossRefGoogle Scholar
  4. 4.
    Van den Beuken-van Everdingen MH, De rijke JM, Kessels AG, Schouten HC, Van kleef M, Patijn J. Prevalence of pain in patients with cancer: a systematic review of the past 40 years. Ann Oncol. 2007;18(9):1437–49.CrossRefGoogle Scholar
  5. 5.
    Pachman DR, Barton DL, Watson JC, Loprinzi CL. Chemotherapy-induced peripheral neuropathy: prevention and treatment. Clin Pharmacol Ther. 2011;90(3):377–87.CrossRefGoogle Scholar
  6. 6.
    Mehta N, Mehta A, Gulati A. Neuropathic pain in cancer. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation: principles and practice. New York: Demos Medical; 2009.Google Scholar
  7. 7.
    Jung BF, Herrmann D, Griggs J, Oaklander AL, Dworkin RH. Neuropathic pain associated with non-surgical treatment of breast cancer. Pain. 2005;118(1–2):10–4.CrossRefGoogle Scholar
  8. 8.
    Custodio CM. Electrodiagnosis in cancer. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation: principles and practice. New York: Demos Medical; 2009.Google Scholar
  9. 9.
    Preston DC, Shapiro BE. Electromyography and neuromuscular disorders: clinical-electrophysiologic correlations. Philadelphia: Butterworth-Helnemann; 2005.Google Scholar
  10. 10.
    Stübgen JP. Neuromuscular disorders in systemic malignancy and its treatment. Muscle Nerve. 1995;18(6):636.CrossRefGoogle Scholar
  11. 11.
    Sayko O, Dillingham T. Radiculopathy in cancer. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation: principles and practice. New York: Demos Medical; 2009.Google Scholar
  12. 12.
    Kuntzer T, Antoine JC, Steck AJ. Clinical features and pathophysiological basis of sensory neuronopathies (ganglionopathies). Muscle Nerve. 2004;30(3):255–68.CrossRefGoogle Scholar
  13. 13.
    Ferrante MA. Plexopathy in cancer. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation: principles and practice. New York: Demos Medical; 2009.Google Scholar
  14. 14.
    Ladha SS, Spinner RJ, Suarez GA, Amrami KK, Dyck PJ. Neoplastic lumbosacral radiculoplexopathy in prostate cancer by direct perineural spread: an unusual entity. Muscle Nerve. 2006;34(5):659–65.CrossRefGoogle Scholar
  15. 15.
    Delanian S, Lefaix JL, Pradat PF. Radiation-induced neuropathy in cancer survivors. Radiother Oncol. 2012;105(3):273–82.CrossRefGoogle Scholar
  16. 16.
    Shin HY, Park HJ, Choi YC, Kim SM. Clinical and electromyographic features of radiation-induced lower cranial neuropathy. Clin Neurophysiol. 2013;124(3):598–602.CrossRefGoogle Scholar
  17. 17.
    Stubblefield MD, Kim A, Riedel ER, Ibanez K. Carpal tunnel syndrome in breast cancer survivors with upper extremity lymphedema. Muscle Nerve. 2015;51(6):864–9.CrossRefGoogle Scholar
  18. 18.
    Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. J Neurol. 2002;249(1):9–17.CrossRefGoogle Scholar
  19. 19.
    Lehky TJ, Leonard GD, Wilson RH, Grem JL, Floeter MK. Oxaliplatin-induced neurotoxicity: acute hyperexcitability and chronic neuropathy. Muscle Nerve. 2004;29(3):387–92.CrossRefGoogle Scholar
  20. 20.
    Hershman DL, Lacchetti C, Dworkin RH, et al. Prevention and management of chemotherapy-induced peripheral neuropathy in survivors of adult cancers: American Society of Clinical Oncology clinical practice guideline. J Clin Oncol. 2014;32(18):1941–67.CrossRefGoogle Scholar
  21. 21.
    Postma TJ, Heimans JJ. Grading of chemotherapy-induced peripheral neuropathy. Ann Oncol. 2000;11:509–13.CrossRefGoogle Scholar
  22. 22.
    Smith EM, Pang H, Cirrincione C, et al. Effect of duloxetine on pain, function, and quality of life among patients with chemotherapy-induced painful peripheral neuropathy: a randomized clinical trial. JAMA. 2013;309(13):1359–67.CrossRefGoogle Scholar
  23. 23.
    Barton DL, et al. A double blind placebo controlled trial of a topical treatment for chemotherapy-induced peripheral neuropathy: NCCTG trial N06CA. Support Care Cancer. 2011;19:833–41.CrossRefGoogle Scholar
  24. 24.
    Cata JP, Cordella JV, Burton AW, Hassenbusch SJ, Weng HR, Dougherty PM. Spinal cord stimulation relieves chemotherapy-induced pain: a clinical case report. J Pain Symptom Manag. 2004;27(1):72–8.CrossRefGoogle Scholar
  25. 25.
    Abd-elsayed A, Schiavoni N, Sachdeva H. Efficacy of spinal cord stimulators in treating peripheral neuropathy: a case series. J Clin Anesth. 2016;28:74–7.CrossRefGoogle Scholar
  26. 26.
    Koyyalagunta D, Bruera E, Solanki DR, et al. A systematic review of randomized trials on the effectiveness of opioids for cancer pain. Pain Physician. 2012;15(3 Suppl):ES39–58.PubMedGoogle Scholar
  27. 27.
    Cassileth BR, Keefe FJ. Integrative and behavioral approaches to the treatment of cancer-related neuropathic pain. Oncologist. 2010;15(Suppl 2):19–23.CrossRefGoogle Scholar
  28. 28.
    Montgomery GH, Weltz CR, Seltz M, Bovbjerg DH. Brief presurgery hypnosis reduces distress and pain in excisional breast biopsy patients. Int J Clin Exp Hypn. 2002;50(1):17–32.CrossRefGoogle Scholar
  29. 29.
    Sheinfeld gorin S, Krebs P, Badr H, et al. Meta-analysis of psychosocial interventions to reduce pain in patients with cancer. J Clin Oncol. 2012;30(5):539–47.CrossRefGoogle Scholar
  30. 30.
    Santiago-Palma J, Payne R. Palliative care and rehabilitation. Cancer. 2001;92:1049–52.CrossRefGoogle Scholar
  31. 31.
    Paice JA. Mechanisms and management of neuropathic pain in cancer. J Support Oncol. 2003;1(2):107–20.PubMedGoogle Scholar
  32. 32.
    Kumar SP, Adhikari P, Jeganathan PS, D’Souza SC. Physiotherapy management of painful diabetic peripheral neuropathy: a current concepts review of treatment methods for clinical decision-making in practice and research. Int J Curr Res Rev. 2010;2:29–39.Google Scholar
  33. 33.
    Dobson JL, Mcmillan J, Li L. Benefits of exercise intervention in reducing neuropathic pain. Front Cell Neurosci. 2014;8:102.CrossRefGoogle Scholar
  34. 34.
    Raphael J, Hester J, Ahmedzai S, et al. Cancer pain: part 2: physical, interventional and complimentary therapies; management in the community; acute, treatment-related and complex cancer pain: a perspective from the British pain society endorsed by the UK Association of Palliative Medicine and the Royal College of general practitioners. Pain Med. 2010;11(6):872–96.CrossRefGoogle Scholar
  35. 35.
    Rostami R, Mittal SO, Radmand R, Jabbari B. Incobotulinum toxin-a improves post-surgical and post-radiation pain in cancer patients. Toxins (Basel). 2016;8(1):E22.CrossRefGoogle Scholar
  36. 36.
    Dessy LA, Maruccia M, Mazzocchi M, Scuderi N. Treatment of post mastectomy pain syndrome after mastopexy with botulinum toxin. J Plast Reconstr Aesthet Surg. 2014;67(6):873–4.CrossRefGoogle Scholar
  37. 37.
    Fabregat G, Asensio-samper JM, Palmisani S, Villanueva-pérez VL, De andrés J. Subcutaneous botulinum toxin for chronic post-thoracotomy pain. Pain Pract. 2013;13(3):231–4.CrossRefGoogle Scholar
  38. 38.
    Andima L, Gulati A, Cubert K. Interventional pain management in the patient with cancer. In: Stubblefield MD, O’Dell MW, editors. Cancer rehabilitation: principles and practice. New York: Demos Medical; 2009.Google Scholar
  39. 39.
    Wisotzky EM, Saini V, Kao C. Ultrasound-guided intercostobrachial nerve block for intercostobrachial neuralgia in breast cancer patients: a case series. PM R. 2016;8(3):273–7.CrossRefGoogle Scholar
  40. 40.
    Mishra S, Rana SP, Upadhyay SP, Bhatnagar S. Use of epidural steroid as an adjuvant in neuropathic cancer pain management: a case report. Am J Hosp Palliat Care. 2010;27(7):482–5.CrossRefGoogle Scholar
  41. 41.
    Stadler JA, Ellens DJ, Rosenow JM. Deep brain stimulation and motor cortical stimulation for neuropathic pain. Curr Pain Headache Rep. 2011;15(1):8–13.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Eric Leung
    • 1
  1. 1.Department of Physical Medicine and RehabilitationNorthwell HealthManhassetUSA

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