Assessment of neuropathic pain following cancer treatment

Abstract

Neuropathic cancer pain (NCP) is prevalent affecting up to 58% of those with persistent pain following cancer treatment. Neuropathic pain can develop from malignancy, after neural tissue insult during surgery and/or exposure to radiation or neurotoxic agents used as part of cancer treatment regimens. Pain following cancer treatment is commonly under‐treated and one barrier identified is poor recognition of pain and inadequate assessment. Recognition of the presence of NCP is important to inform pain management, which is challenging to treat and warrants the use of specific treatments to target neuropathic mechanisms. In this review, approaches for screening and classifying NCP are described. These include screening questionnaires and the application of the updated neuropathic pain grading system in a cancer context. The evidence from neuropathic pain related assessments in cancer populations is provided and highlighted under different neuropathic pain grades. Recommendations for assessment in practice are provided.

Novel drug treatments for pain in advanced cancer and serious illness: a focus on neuropathic pain and chemotherapy-induced peripheral neuropathy

“…The improvement in life expectancy of patients with cancer and the common use of chemotherapy agents such as paclitaxel and oxaliplatin for lung, breast, pancreatic, colorectal, esophageal, and prostate cancer has led to a significant prevalence of neuropathic pain among patients living with cancer or in cancer survivorship. 1 Bortezomib, Revlimid, and vinca alkaloids cause neuropathic sensory and motor symptoms in patients treated for hematologic malignancies. 2 – 6 In addition to chemotherapy, other anti-cancer treatments, including surgery and radiation therapy, may cause chronic pain, with a subset of patients experiencing neuropathic pain.…”

Pain after cancer: Time to move towards a mechanism‐based approach!

“…Patients receiving taxane‐ or platinum‐based chemotherapy regimens, which are commonly used to treat breast and colon cancer, are most likely to experience the most common symptoms of CIPN, including sensory and motor symptoms in the hands and/or feet such as numbness, tingling, cramping, weakness, and burning pain (Chan et al, 2018; Chan et al, 2019; Seretny et al, 2014; Staff NP et al, 2017). Moloney and Lenoir (2024) elaborate on the assessment of neuropathic pain after cancer treatment. They provide evidence from neuropathic pain‐related assessments in cancer populations and give recommendations for assessment in practice.…”

Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits

“…Cancer is often associated with chronic and persistent pain syndromes [1][2][3][4] depending on the type of cancer, 4 tumour stage, therapies, [5][6][7] disease course and performance status. 3,8,9 Cancer-related pain is a multidimensional symptom that includes physical, psychosocial, emotional and spiritual components.…”

“…[20][21][22][23][24][25] Many patients with cancer require emergency department consultation for acute oncological pain, and a high percentage are admitted to hospital to manage pain, thus increasing healthcare costs. 26,27 Therefore, patient characteristics and cancer pain patterns (precipitating factors, intensity, duration, frequency and types of pain) 7,[28][29][30] should be carefully assessed through a detailed history and physical examination using a variety of available and validated tools. [31][32][33][34][35] Despite the detrimental impact of pain on cancer patients, caregivers and healthcare providers, it remains underestimated and undertreated.…”