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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):

Richard M. Gordon-Williams

and Anthony H. Dickenson

DOI:
10.1093/med/9780199656097.003.0092
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date: 07 May 2021

Cancer pain involves a myriad of peripheral changes in the function of tissue 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 that can come some way towards explaining ongoing pain, hyperalgesia, and allodynias that patients with cancer and other terminal illnesses such as HIV/AIDs experience. Finally, changes induced by cancer at the level of the brain are discussed. The mechanisms of action of therapies, both existing and potential novel approaches, are included at peripheral and central levels.

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