Cancer Pain

Cancer Pain is a topic covered in the Washington Manual of Medical Therapeutics.

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Washington Manual

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  • The two main mechanisms for pain are nociceptive (somatic or visceral) and neuropathic.
    • Nociceptive pain is caused by stimulation of pain receptors and neuropathic pain by direct injury to the peripheral nervous system or CNS.
    • Somatic pain typically occurs with bone metastases, musculoskeletal inflammation, or after surgery and is characterized by a well-localized, dull, or aching pain.
    • Visceral pain results from tumor infiltration and compression or distention of viscera and is described as diffuse, deep, squeezing, and pressure-like sensation.
    • Neuropathic pain occurs because of tumor infiltration of peripheral nerves, roots, or spinal cord, as well as chemical injury caused by chemotherapy, radiotherapy, or surgery. This pain is described as a sharp or burning sensation.
  • These three types of pain may occur alone or in combination in the same patient.
  • Cancer pain in adults may be classified into three levels on the basis of a 0–10 numerical scale: mild pain (1–3), moderate pain (4–6), and severe pain (7–10).

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