- Section 1 The worldwide status of palliative care
- Section 2 The challenge of palliative medicine
- Section 3 Service delivery issues in palliative care
- Section 4 The interdisciplinary team
- Section 5 Ethical issues
- Section 6 Communication and palliative medicine
- Section 7 Assessment tools and Informatics
- Section 8 Common symptoms and disorders
- Section 9 Common symptoms and disorders: pain
- 9.1 Principles of drug therapy: focus on opioids
- 9.2 Pathophysiology of pain in cancer and other terminal illnesses
- 9.3 Definition and assessment of chronic pain in advanced disease
- 9.4 Opioid therapy: optimizing analgesic outcomes
- 9.5 Opioid therapy: managing risks of abuse, addiction, and diversion
- 9.6 Non-opioid analgesics
- 9.7 Adjuvant analgesics
- 9.8 Interventional approaches for chronic pain
- 9.9 Neurostimulation in pain management
- 9.10 Rehabilitation medicine approaches to pain management
- 9.11 Psychological and psychiatric interventions in pain control
- 9.12 Complementary therapies in pain management
- 9.13 Paediatric pain control
- Section 10 Common symptoms and disorders: gastrointestinal symptoms
- Section 11 Common symptoms and disorders: skin problems
- Section 12 Issues in populations with cancer
- Section 13 Cancer pain syndromes
- Section 14 Cancer-associated disorders
- Section 15 Issues in populations with non-cancer illnesses
- Section 16 Issues of the very young and the very old
- Section 17 Psychosocial and spiritual issues in palliative medicine
- Section 18 The terminal phase
- Section 19 Research in palliative medicine
(p. 506) Pathophysiology of pain in cancer and other terminal illnesses
- Chapter:
- (p. 506) 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
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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- Section 1 The worldwide status of palliative care
- Section 2 The challenge of palliative medicine
- Section 3 Service delivery issues in palliative care
- Section 4 The interdisciplinary team
- Section 5 Ethical issues
- Section 6 Communication and palliative medicine
- Section 7 Assessment tools and Informatics
- Section 8 Common symptoms and disorders
- Section 9 Common symptoms and disorders: pain
- 9.1 Principles of drug therapy: focus on opioids
- 9.2 Pathophysiology of pain in cancer and other terminal illnesses
- 9.3 Definition and assessment of chronic pain in advanced disease
- 9.4 Opioid therapy: optimizing analgesic outcomes
- 9.5 Opioid therapy: managing risks of abuse, addiction, and diversion
- 9.6 Non-opioid analgesics
- 9.7 Adjuvant analgesics
- 9.8 Interventional approaches for chronic pain
- 9.9 Neurostimulation in pain management
- 9.10 Rehabilitation medicine approaches to pain management
- 9.11 Psychological and psychiatric interventions in pain control
- 9.12 Complementary therapies in pain management
- 9.13 Paediatric pain control
- Section 10 Common symptoms and disorders: gastrointestinal symptoms
- Section 11 Common symptoms and disorders: skin problems
- Section 12 Issues in populations with cancer
- Section 13 Cancer pain syndromes
- Section 14 Cancer-associated disorders
- Section 15 Issues in populations with non-cancer illnesses
- Section 16 Issues of the very young and the very old
- Section 17 Psychosocial and spiritual issues in palliative medicine
- Section 18 The terminal phase
- Section 19 Research in palliative medicine