Journal
NEUROSCIENTIST
Volume 20, Issue 5, Pages 546-562Publisher
SAGE PUBLICATIONS INC
DOI: 10.1177/1073858414525828
Keywords
cancer pain; cancer; tumor; pain; sensory system
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Funding
- National Institutes of Health/National Institute of Dental and Craniofacial Research [R01DE019796, R21DE018561]
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The global burden of cancer pain is enormous and opioids, despite their side effects, remain the primary therapeutic approach. The cause of cancer pain is unknown. Mechanisms driving cancer pain differ from those mechanisms responsible for inflammatory and neuropathic pain. The prevailing hypothesis put forward to explain cancer pain posits that cancers generate and secrete mediators which sensitize and activate primary afferent nociceptors in the cancer microenvironment. Moreover, cancers induce neurochemical reorganization of the spinal cord, which contributes to spontaneous activity and enhanced responsiveness. The purpose of this review, which covers clinical and preclinical studies, is to highlight those peripheral and central mechanisms responsible for cancer pain. The challenges facing neuroscientists and clinicians studying and ultimately treating cancer pain are discussed.
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