Oral Pain in the Cancer Patient.

Abstract

Oral pain due to cancer and associated treatments is common. The prevalence and severity of oral cancer is high. Painful oral mucositis develops in head and neck cancer patients following surgery and associated radiation therapy and/or chemotherapy. In addition, oral pain, including pain from mucositis, occurs in patients receiving chemotherapy for cancers of the hematopoietic system and cancers at other anatomic sites. Despite pain management practices that include high-dose opioid analgesics, patients rarely obtain relief from either head and neck cancer pain or mucositis pain. Because oral pain in cancer patients is likely due to both nociceptive and neuropathic mechanisms, effective management of pain requires treatments for both processes. As knowledge of the pathophysiology of oral pain in cancer patients increases, new approaches for the prevention and management are anticipated. This article focuses on the emerging evidence that supports the molecular mechanisms and the unique oral micro-neuroanatomy that in combination produce the severe oral pain experienced by cancer patients. In addition, this article summarizes the current state of clinical management of oral mucositis pain.

• Authors: Joel B Epstein, Christine Miaskowski
• Journal: Journal of the National Cancer Institute. Monographs (J Natl Cancer Inst Monogr) Vol. 2019 Issue 53 (08 01 2019) ISSN: 1745-6614 [Electronic] United States
• PMID: 31425595 (Publication Type: Journal Article, Review)
• Copyright: © The Author(s) 2019. Published by Oxford University Press. All rights reserved. For permissions, please email: [email protected].

Chemical References

• Biomarkers

Topics

• Antineoplastic Combined Chemotherapy Protocols (adverse effects, therapeutic use)
• Biomarkers
• Cancer Pain (diagnosis, etiology, metabolism, therapy)
• Disease Management
• Disease Susceptibility
• Humans
• Mouth Neoplasms (complications, therapy)
• Neoplasms (complications, therapy)
• Outcome Assessment, Health Care
• Pain (diagnosis, etiology, metabolism)
• Pain Management
• Stomatitis (etiology)