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      Recent advances in understanding and managing cancer pain

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          Cancer pain remains a significant clinical problem worldwide. Causes of cancer pain are multifactorial and complex and are likely to vary with an array of tumor-related and host-related factors and processes. Pathophysiology is poorly understood; however, new laboratory research points to cross-talk between cancer cells and host’s immune and neural systems as an important potential mechanism that may be broadly relevant to many cancer pain syndromes. Opioids remain the most effective pharmaceuticals used in the treatment of cancer pain. However, their role has been evolving due to emerging awareness of risks of chronic opioid therapy. Despite extensive research efforts, no new class of analgesics has been developed. However, many potential therapeutic targets that may lead to the establishment of new pharmaceuticals have been identified in recent years. It is also expected that the role of non-pharmacological modalities of treatment will grow in prominence. Specifically, neuromodulation, a rapidly expanding field, may play a major role in the treatment of neuropathic cancer pain provided that further technological progress permits the development of non-invasive and inexpensive neuromodulation techniques.

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              Facial expression is widely used as a measure of pain in infants; whether nonhuman animals display such pain expressions has never been systematically assessed. We developed the mouse grimace scale (MGS), a standardized behavioral coding system with high accuracy and reliability; assays involving noxious stimuli of moderate duration are accompanied by facial expressions of pain. This measure of spontaneously emitted pain may provide insight into the subjective pain experience of mice.

                Author and article information

                F1000Research (London, UK )
                20 June 2017
                : 6
                [1 ]Department of Hematology and Medical Oncology, Fox Chase Cancer Center/Temple Health, Philadelphia, PA, USA
                Author notes

                Competing interests: The author declares that he has no competing interests.

                Copyright: © 2017 Chwistek M

                This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                The author(s) declared that no grants were involved in supporting this work.
                Anesthetic Mechanisms
                Cancer Therapeutics
                Drug Discovery & Design
                Head & Neck Cancers
                Molecular Pharmacology
                Musculoskeletal Pain & Analgesia
                Neuropharmacology & Psychopharmacology
                Pain: Basic Science
                Pain Management: Chronic Clinical
                Peripheral Neuropathies
                Pharmacokinetics & Drug Delivery
                Supportive & Palliative Cancer Care


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