Mechanism-oriented therapy reflects type of pain
Pain in patients with cancer can be caused by the cancer itself, by treatment, or by non-cancer-related concomitant conditions.1, 2
Understanding the likely causes, and the mechanisms involved, in a cancer patient with pain is the key to appropriate management.
The choice of analgesic treatment should reflect the type of pain diagnosis and the underlying nature of the patient’s pain, with treatments chosen to fit patients’ needs.
Whenever possible, pharmacological therapy should be mechanism-orientated, addressing nociceptive, neuropathic, or mixed nociceptive/neuropathic pain.
In the case of neuropathic pain caused by cancer related infiltration, non-opioids, opioids, antidepressants, anticonvulsants, corticosteroids, TENS and interventional procedures may be considered.
Rarely does one drug treatment offer effective pain relief, and often different classes of drugs need to be combined to achieve adequate levels of pain relief.
Treatment with a single drug rarely offers effective pain relief, and often different classes of drugs need to be combined to achieve adequate levels of pain relief.
1 Marcus DA. Epidemiology of Cancer Pain. Curr Pain Headache Rep. 2011;15:231-4.
2 Gutgsell T et al. A prospective study of the pathophysiology and clinical characteristics of pain in a palliative medicine population. Am J Hosp Palliat Care. 2003; 20:140-8.