Cancer Pain

More than 80% of cancer patients will develop pain during the course of their disease or treatment.1 Chronic pain in cancer patients is of particular concern, with approximately 1/3 of cancer patients experiencing pain symptoms even after curative therapy.2 Pain sources in cancer are very diverse. In many cases, tumor growth can lead to damage of inflammation of neurons, pressure and compression of organs and tissues, muscle mobilization or increased tension, all resulting in pain.3 Radiation treatments, chemotherapy and surgery are often associated with pain as a result of cancer therapies.

Cancer pain is manageable, although often undertreated. Pharmacological treatment of cancer pain is generally effective in 90% of patients; however side effects of pharmacological treatment are often not well tolerated, leading to diminished quality-of-life.2Interventional pain techniques can be applied, even at early stages, to address pain while minimizing use of heavy opioids in cancer pain management. Epidural administration of analgesics can be used to target pain while avoiding systemic side effects.4 Upper abdominal pain is often present in pancreatic and stomach cancers. Celiac plexus blocks have proven effective in treating abdominal pains associated with digestive and pancreatic cancers, with patients reporting reduced pain (90%) or no pain (56%) extending 3 months after treatment.5 Pain from rectal, pelvic or perineal malignancies may also respond well to procedures such as a Ganglion Impar block.

References

  1. Bruera, E. & Kim, H. N. Cancer pain. JAMA : the journal of the American Medical Association290, 2476–9 (2003)
  2. National Cancer Institute. Pain (PDQ®). http://www.cancer.gov/cancertopics/pdq/supportivecare/pain/HealthProfessional/page1. Accessed July 28, 2014.
  3. Vadalouca, A. et al. Pharmacological treatment of neuropathic cancer pain: a comprehensive review of the current literature. Pain practice 12, 219–51 (2012)
  4. Vissers, K. et al. 23. Pain in patients with cancer. Pain practice 11, 453–75 (2011).
  5. Eisenberg E. et al. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 80, 290–295 (1995).