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Managing Local Pain

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Basics of Planning and Management of Patients during Radiation Therapy

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Abstract

Pain in cancer patients may be a result of tissue damage by the tumour, such as bone destruction by metastasis or invasion of the nerve plexus by cancer, or from the treatment received (like radiotherapy or surgery). At the time of diagnosis, about one-third of cancer patients suffer from pain, while in advanced stages, at least two-thirds suffer. Cancer itself causes about 80–90% of pain syndromes, while in 20–40% of cases, pain is therapy induced. Only 2–4% of cancer patients suffer from chronic pain unrelated to cancer. Irradiation of normal tissues, especially those with a rapid growth turnover rate, causes cell death and triggers a cascade of proinflammatory cytokines, thrombotic factors and growth factors, causing local painful reactions. Both early and late stages of cancer can result in patients presenting with severe pain, though it is more common in advanced stages. Current medical management of pain is one of the many modalities and is based on the World Health Organization (WHO)’s concept of an “analgesic ladder” which involves a stepwise approach to the use of analgesic drugs and is essentially a framework of principles rather than a rigid protocol.

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Authors and Affiliations

  1. Department of Radiotherapy, Regional Cancer Centre, JIPMER Department of Radiotherapy, Puducherry, India

    Ashutosh Mukherji

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  1. Ashutosh Mukherji
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Mukherji, A. (2018). Managing Local Pain. In: Basics of Planning and Management of Patients during Radiation Therapy. Springer, Singapore. https://doi.org/10.1007/978-981-10-6659-7_25

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  • DOI: https://doi.org/10.1007/978-981-10-6659-7_25

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  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-6658-0

  • Online ISBN: 978-981-10-6659-7

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