Cancer Pain Assessment and Classification
Abstract
:1. Introduction
2. Etiology of Pain in Cancer Patients
3. Clinical Presentation and Assessment of Pain
3.1. Pain Intensity
3.2. Pain Site
3.3. Pain Syndromes
3.4. Timing and Temporal Variation
4. Cancer Pain Mechanisms and Pathophysiology
Neuropathic Pain
- history of relevant neurological lesion or disease, including pain descriptors, suggestive of pain being related to a neurological lesion and not other causes;
- pain distribution neuroanatomically plausible;
- pain associated with the presence of sensory signs in the same neuroanatomically plausible;
- diagnostic tests confirming a lesion or disease of the somatosensory systems, explaining the pain perceived by the patient.
5. Patient Characteristics and Disease Factors
6. Cancer Pain Classification Systems
6.1. International Association for the Study of Pain (IASP) Taxonomy
- anatomical region or pain site,
- system responsible for the pain perceived,
- temporal characteristics and pattern of pain occurrence,
- pain intensity and time since onset,
- etiology.
6.2. ICD-11
6.3. Edmonton Classification System for Cancer Pain (ECS-CP)
6.4. The Cancer Pain Prognostic Scale
7. Clinical Relevance
7.1. Pain Assessment Clinical Relevance
7.2. Classification Systems Clinical Relevance
8. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Neoplastic damage to bone and joints | 1. Base of the skull syndrome. Headache due to calvarial, maxillary, or mandibular lesion |
2. Vertebral syndromes, including sacrum | |
3. Pelvic, long bones, direct infiltration of a joint | |
4. Generalized bone pain:
| |
5. Chest wall pain from rib lesion | |
6. Pathologic fracture of:
| |
Neoplastic damage to viscera | 7. Esophageal mediastinal pain. |
8. Shoulder pain from diaphragmatic infiltration
| |
9. Epigastric pain from pancreas or other upper abdominal neoplasm “Midline rostral retroperitoneal syndrome” | |
10. Diffuse abdominal pain from abdominal or peritoneal disease:
| |
11. Suprapubic pain from infiltration of bladder. Perineal pain from infiltration of rectum or perirectal tissue (including vagina) | |
12. Obstruction of ureter | |
Neoplastic damage to soft tissue and miscellaneous | 13. Damage to oral mucous membranes. Infiltration of skin and subcutaneous tissue |
14. Infiltration of muscle and fascia of in the chest or abdominal wall. Infiltration of muscle and fascia in the limbs | |
15. Infiltration of muscle and fascia in the head and neck | |
16. Retroperitoneal tissue infiltration excluding rostral retroperitoneal syndrome | |
17. Pleural infiltration | |
Lesions of Nervous Tissue | 18. Peripheral nerve syndromes
|
19. Radiculopathy or cauda equina syndrome
| |
20. Plexopathy
| |
21. Cranial neuropathy
| |
22. Pain due to central nervous system lesion
| |
23. Headache due to intracranial hypertension | |
24. Neck, back pain or headache due to leptomeningeal disease |
Pain Type | Pain Origin and Syndromes | |
---|---|---|
Nociceptive | Deep somatic | Bone marrow expansion and osteolysis. Spleen and liver capsulae distension by tumor infiltration and organ enlargement; intracranial hypertension (meningeal and/or brain tumor involvement) |
Superficial somatic | Mucositis, cutaneous lesions | |
Visceral | Infiltration and/or compression of viscera cava by abdominal nodes, spleen, and liver enlargement | |
Neuropathic | Peripheral neuropathic | Neuropathies due to para-proteins. Amyloidosis. Plexopathy by tumor invasion and/or node enlargement compression (lymphomas) |
Central Neuropathic | CNS damage and/or tumor involvement | |
Mixed | Neuropathic + somatic | Meningosis, peripheral nerve damage, and/or tumor involvement |
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Caraceni, A.; Shkodra, M. Cancer Pain Assessment and Classification. Cancers 2019, 11, 510. https://doi.org/10.3390/cancers11040510
Caraceni A, Shkodra M. Cancer Pain Assessment and Classification. Cancers. 2019; 11(4):510. https://doi.org/10.3390/cancers11040510
Chicago/Turabian StyleCaraceni, Augusto, and Morena Shkodra. 2019. "Cancer Pain Assessment and Classification" Cancers 11, no. 4: 510. https://doi.org/10.3390/cancers11040510
APA StyleCaraceni, A., & Shkodra, M. (2019). Cancer Pain Assessment and Classification. Cancers, 11(4), 510. https://doi.org/10.3390/cancers11040510