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Pathophysiology of pain in cancer and other terminal illnesses 

Pathophysiology of pain in cancer and other terminal illnesses
Chapter:
Pathophysiology of pain in cancer and other terminal illnesses
Author(s):

Anthony H. Dickenson

, and Richard Gordon-Williams

DOI:
10.1093/med/9780198821328.003.0035
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date: 30 June 2022

Cancer pain involves a myriad of peripheral changes in the function of tissues and nerves, at the site of the tumour growth, as well as a number of consequent changes in the processing of pain messages at the spinal cord level with implications for the pain experience at higher centres. This chapter reviews the changes in peripheral pain signalling, notes the likely prevalence of both inflammatory and neuropathic components, and describes the altered events at spinal levels and within the circuits of pain in higher brain areas that can help explain the ongoing pain, hyperalgesia, and allodynia that patients with cancer and other chronic illnesses, such as HIV/AIDs, experience. The mechanisms of action of therapies, both existing and potential novel approaches, are also described. The importance of these processes in the development and treatment of chronic pain is an emerging issue, particularly as the problem of persistent pain in cancer survivors increases in prevalence.

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