Neuropathic component of pain in cancer

Abstract

The prevalence of neuropathic pain in cancer patients is increasing as more patients are exposed to neurotoxic chemotherapies including taxane and platinum agents. Up to 40 % of cancer patients may experience neuropathic pain during the course of the disease. The neuropathic cancer pain generally originates from tumour-related and treatment-related causes. Various mechanisms such as mechanical or chemical destruction of neurons, distortion of the surrounding nerve environment, and central sensitisation are involved in the development of neuropathic cancer pain. No single symptom or sign could confirm neuropathic pain, but diagnosis only can be established by a combination of unique symptoms, physical examinations, and appropriate tests. Opioids are ­recommended as first-line agents for the treatment of neuropathic cancer pain. Antidepressants and anticonvulsants have beneficial effects as adjuvants.