BONE CANCER PAIN
CHEMOTHERAPY-INDUCED PERIPHERAL NEUROPATHY
Pain related to cancer may have different origins:
Neuropathic pain directly caused by cancer can result from compression of the nerve or direct infiltration by the growing tumor, or secondarily from changes in the neuronal milieu resulting from cancer growth, or from the resulting inflammatory response. For example, in the laboratory, cancer pain related to a bone tumor can be convincingly modeled.
Neuropathic pain can also be associated with the standard treatment options, notably surgery, radiotherapy and chemotherapy.
Chemotherapy-induced pain is a direct consequence of cancer treatment with platinum salts, taxanes and vinca alkaloids. The dose-limiting toxicity accumulates with time and represents a major problem due to the painful neuropathy that ensues. Sensory neuropathies, evoking tingling sensations, paraesthesias or numbness in the distal extremities are reported in these patients. When administered in an experimental setting, these chemicals produce neuropathies that may be used to study prevention as well as restorative treatment.