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The MASCC Textbook of Cancer Supportive Care and Survivorship pp 17–35Cite as

Cancer Pain

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Abstract

Cancer pain is a problem in a significant subset of patients presenting with cancer and is a major symptom in 60–70% of those with advanced cancer. Pain in those with cancer is influenced by beliefs, interference with daily activities, and catastrophizing, and in turn, beliefs, physical function, and nihilism influence cancer severity. Pain is generated through several peripheral and central mechanisms. Classification of pain has classically been categorized as nociceptive, visceral, and neuropathic. Bone pain has unique and variable pathophysiology which is a mixture of neuropathic and nociceptive mechanisms. Treatment of cancer pain is guided by the World Health Organization analgesic ladder, and analgesic dosing strategies are based largely on opioid pharmacology. The use of adjuvant analgesic pain improves opioid responses and is opioid sparing in certain circumstances. The best strategy to manage cancer pain involves multiple modality therapies including surgery, interventional pain procedures, radiation therapy, and cognitive behavioral therapy.

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  1. Department of Palliative Care, Geisinger Medical System, Danville, PA, USA

    Mellar P. Davis

  2. Cleveland Clinic Lerner School of Medicine, Case Western Reserve University, Cleveland, OH, USA

    Mellar P. Davis

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Davis, M.P. (2018). Cancer Pain. In: Olver, I. (eds) The MASCC Textbook of Cancer Supportive Care and Survivorship. Springer, Cham. https://doi.org/10.1007/978-3-319-90990-5_2

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