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2014 ; 8
(2
): 83-90
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Bone cancer pain: from mechanism to therapy
#MMPMID24792411
Mantyh PW
Curr Opin Support Palliat Care
2014[Jun]; 8
(2
): 83-90
PMID24792411
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PURPOSE OF REVIEW: To review how common cancers such as breast, lung, and
prostate cancers drive significant and frequently life-altering pain when the
cells metastasize to bones. RECENT FINDINGS: Similar to cancer, the factors that
drive bone cancer pain evolve and change with disease progression. Bone cancer
pain has both a nociceptive and neuropathic component. The nociceptive component
is driven by the release of algogenic substances by tumor and their associated
stromal cells, acidosis caused by bone-destroying osteoclasts, and mechanical
destabilization and fracture of the bone. The neuropathic component is induced by
tumor cell growth which injures and destroys the distal ends of nerve fibers that
normally innervate the bone, as well as by inducing a highly pathological
sprouting of both sensory and sympathetic nerve fibers. SUMMARY: There is both a
nociceptive and neuropathic component of bone cancer pain. In bone cancer pain,
there is frequently a continual afferent drive of sensory nerve fibers that
induces a peripheral and central sensitization. These mechanistic insights have
begun to lead to advances in not only how we understand bone cancer pain but to
the development of new therapies to treat bone cancer pain.
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