Title:Neurophysiological Mechanisms Related to Pain Management in Bone Tumors
Volume: 19
Issue: 3
Author(s): Pablo Romero-Morelos, Erika Ruvalcaba-Paredes, David Garciadiego-Cázares, Martín Pérez-Santos, Samuel Reyes-Long, Alfonso Alfaro-Rodriguez, Mauricio Salcedo, Javier Mancilla-Ramírez and Cindy Bandala*
Affiliation:
- Instituto Nacional de Rehabilitacion, “Luis Guillermo Ibarra, Ibarra”, SSA, Ciudad de Mexico,Mexico
Keywords:
Bone pain, treatment, nociceptive, neuropathic, neurological mechanism, novel management.
Abstract:
Background: Primary and metastatic bone tumor incidence has increased in the previous
years. Pain is a common symptom and is one of the most important related factors to the decrease of
quality of life in patients with bone tumor. Different pain management strategies are not completely
effective and many patients afflicted by cancer pain cannot be controlled properly. In this sense, we
need to elucidate the neurophysiology of cancer-induced pain, contemplating other components
such as inflammation, neuropathies and cognitive components regarding bone tumors, and thus
pave the way for novel therapeutic approaches in this field.
Aim: This study aims to identify the neurophysiology of the mechanisms related to pain management
in bone tumors.
Methods: Advanced searches were performed in scientific databases: PubMed, ProQuest, EBSCO,
and the Science Citation index to get information about the neurophysiology mechanisms related to
pain management in bone tumors.
Results: The central and peripheral mechanisms that promote bone cancer pain are poorly understood.
Studies have shown that bone cancer could be related to neurochemicals produced by tumor
and inflammatory cells, coupled with peripheral sensitization due to nerve compression and injury
caused by tumor growth. The activity of mesolimbic dopaminergic neurons, substance P, cysteine/
glutamate antiporter, and other neurochemical dynamics brings us putative strategies to suggest
better and efficient treatments against pain in cancer patients.
Conclusion: Cancer-induced bone pain could include neuropathic and inflammatory pain, but with
different modifications to the periphery tissue, nerves and neurochemical changes in different neurological
levels. In this sense, we explore opportunity areas in pharmacological and nonpharmacological
pain management, according to pain-involved mechanisms in this study.