Noncancer-related pain in daily practice

Abstract

Noncancer-related pain could be experienced by many cancer patients. Many treatments as well as degenerative disorders only distantly related to cancer (e.g. cachexia) may result in persistent, difficult-to-treat pain. Prevalence of this type of pain can be growing as cancer patients tend to live longer with their disease and many of them can be cured, sometimes at the cost of persistent noncancer-related pain. In this chapter, I shall discuss in more details pain that originates from nerve compression due to the atrophy of supporting tissues. This atrophy can be spontaneous as in cachexia, or it may be induced by the frequent and chronic use of corticosteroids, mainly dexamethasone. Another pain problem frequently encountered by patients suffering or cured from cancer is osteoporosis induced by either steroids or opioids. Skin can also get atrophic and is prone to damages, which can be painful and may heal poorly. Specific treatment of noncancer-related pain might help in keeping the opioid and other analgesics doses as low as possible and contribute to better overall pain control and better mobility of the patients.