Principles & Practice of Pain Medicine > Part V. Pain Syndromes > C. Pain in the Terminally Ill > Chapter 44. Cancer Pain Syndromes Stuart W. Hough and Ronald M. Kanner

Overview

"Pain in cancer patients has numerous possible causes. The vast majority of pain syndromes are caused by direct tumor involvement of pain-sensitive structures, a smaller number are treatment-related, and fewer than 10% are unrelated to the cancer. Metastatic disease may invade bone, obstruct a hollow viscus, and compress nerve or spinal cord. Radiation treatment may cause fibrosis of nerve or spinal cord. Chemotherapeutic agents may cause peripheral neuropathy, aseptic bone necrosis, and predispose to painful opportunistic infections. Surgical treatment leads to acute postoperative pain, and may cause deafferentation pain if major nerves or nerve plexi are cut. In any given patient, one or more of these factors may be in play, and more than 50% of cancer patients with pain have more than one source of pain.¹..."