Bone Pain in Cancer Patients: Mechanisms and Current Treatment.
Renata ZajączkowskaMagdalena Kocot-KępskaWojciech LeppertJerzy WordliczekPublished in: International journal of molecular sciences (2019)
The skeletal system is the third most common site for cancer metastases, surpassed only by the lungs and liver. Many tumors, especially those of the breast, prostate, lungs, and kidneys, have a strong predilection to metastasize to bone, which causes pain, hypercalcemia, pathological skeletal fractures, compression of the spinal cord or other nervous structures, decreased mobility, and increased mortality. Metastatic cancer-induced bone pain (CIBP) is a type of chronic pain with unique and complex pathophysiology characterized by nociceptive and neuropathic components. Its treatment should be multimodal (pharmacological and non-pharmacological), including causal anticancer and symptomatic analgesic treatment to improve quality of life (QoL). The aim of this paper is to discuss the mechanisms involved in the occurrence and persistence of cancer-associated bone pain and to review the treatment methods recommended by experts in clinical practice. The final part of the paper reviews experimental therapeutic methods that are currently being studied and that may improve the efficacy of bone pain treatment in cancer patients in the future.
Keyphrases
- chronic pain
- neuropathic pain
- pain management
- spinal cord
- bone mineral density
- prostate cancer
- randomized controlled trial
- clinical practice
- squamous cell carcinoma
- soft tissue
- systematic review
- oxidative stress
- combination therapy
- coronary artery disease
- bone loss
- cardiovascular events
- body composition
- drug induced
- high glucose
- squamous cell
- bone regeneration