Translational medicine: Cancer pain mechanisms and management

A. Delaney, S. M. Fleetwood-Walker, L. A. Colvin, M. Fallon (Lead / Corresponding author)

Research output: Contribution to journalReview article

71 Citations (Scopus)

Abstract

Cancer-induced bone pain (CIBP) is a major clinical problem with up to 85% of patients with bony metastases having pain, often associated with anxiety and depression, reduced performance status, and a poor quality of life. Malignant bone disease creates a chronic pain state through sensitization and synaptic plasticity within the spinal cord that amplifies nociceptive signals and their transmission to the brain. Fifty per cent of patients are expected to gain adequate analgesia from palliative radiotherapy within 4-6 weeks of treatment. Opioid analgesia does make a useful contribution to the management of CIBP, especially in terms of suppressing tonic background pain. However, CIBP remains a clinical challenge because the spontaneous and movement-related components are more difficult to treat with opioids and commonly used analgesic drugs, without unacceptable side-effects. Recently developed laboratory models of CIBP, which show congruency with the clinical syndrome, are contributing to an improved understanding of the neurobiology of CIBP. This chronic pain syndrome appears to be unique and distinct from other chronic pain states, such as inflammatory or neuropathic pain. This has clear implications for treatment and development of future therapies. A translational medicine approach, using a highly iterative process between the clinic and the laboratory, may allow improved understanding of the underlying mechanisms of CIBP to be rapidly translated into real clinical benefits in terms of improved pain management.

Original languageEnglish
Pages (from-to)87-94
Number of pages8
JournalBritish Journal of Anaesthesia
Volume101
Issue number1
DOIs
Publication statusPublished - Jul 2008

Fingerprint

Translational Medical Research
Pain Management
Bone Neoplasms
Pain
Chronic Pain
Analgesia
Opioid Analgesics
Neuronal Plasticity
Neurobiology
Cancer Pain
Bone Diseases
Neuralgia
Analgesics
Spinal Cord
Radiotherapy
Therapeutics
Anxiety
Quality of Life
Depression
Neoplasm Metastasis

Keywords

  • Analgesics, non-opioid
  • Analgesics, opioid
  • Cancer
  • Pain, mechanism

Cite this

Delaney, A. ; Fleetwood-Walker, S. M. ; Colvin, L. A. ; Fallon, M. / Translational medicine : Cancer pain mechanisms and management. In: British Journal of Anaesthesia. 2008 ; Vol. 101, No. 1. pp. 87-94.
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Translational medicine : Cancer pain mechanisms and management. / Delaney, A.; Fleetwood-Walker, S. M.; Colvin, L. A.; Fallon, M. (Lead / Corresponding author).

In: British Journal of Anaesthesia, Vol. 101, No. 1, 07.2008, p. 87-94.

Research output: Contribution to journalReview article

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