Encyclopedia of Pain

2007 Edition

Adjuvant Analgesics in Management of Cancer-Rated Bone Pain

  • Keri L. Fakata
  • Arthur G. Lipman
Reference work entry
DOI: https://doi.org/10.1007/978-3-540-29805-2_105


Malignant Bone Pain; boney pain; cancer-related bone pain


 Adjuvant analgesics in the management of cancer-related bone pain are supplemental treatments that are added to the primary analgesics, usually NSAIDs and opioids. These additional analgesic interventions include radiation, using either palliative  radiotherapy or  radiopharmaceuticals, and two classes of medications,  bisphosphonates and steroids.


Normal bone undergoes constant remodeling in which resorption or formation of bone occurs. The cells involved in these processes are  osteoblasts and  osteoclasts, respectively. These cells respond to signals from several types of mediators, including hormones, prostaglandins, and  cytokines. Tumor cells invade bone and interrupt the balance between osteoblastic and osteoclastic activity, alter bone integrity and produce pain (Mercadante 1997).

Boney cancers can be exquisitely painful. The severity of pain does not always correlate with...

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Copyright information

© Springer-Verlag Berlin Heidelberg 2007

Authors and Affiliations

  • Keri L. Fakata
    • 1
  • Arthur G. Lipman
    • 1
  1. 1.College of Pharmacy and Pain Management CenterUniversity of UtahSalt Lake CityUSA