Management of pain in colorectal cancer patients. (January 2021)

• Record Type: Journal Article
• Authors: Zielińska, Anna; Włodarczyk, Marcin; Makaro, Adam; Sałaga, Maciej; Fichna, Jakub
• Is Part Of: Critical reviews in oncology/hematology. Volume 157(2021)
• Publication Date: 2021-01
• Subjects: Colorectal cancer -- Colorectal cancer pain -- Treatment -- Pain management -- Neuropathic pain; Oncology -- Periodicals; Hematology -- Periodicals; 616.994
• DOI: 10.1016/j.critrevonc.2020.103122
• Languages: English
• ISSNs: 1040-8428

Abstract

Highlights: We present the pathophysiology of colorectal cancer related pain and pharmacological novelties that could improve pain alleviation methods. Despite the presence of guidelines and the availability of opioids, colorectal cancer pain is often inadequately managed. Colorectal cancer pain is prevalent in up to 70% of patients.· Pain in colorectal cancer can be receptor-mediated (nociceptive), neuropathic or psychogenic. Pain in colorectal cancer can be receptor-mediated (nociceptive), neuropathic or psychogenic. WHO guidelines for cancer pain base on the analgesic ladder: non-opioids for the 1 st, weak opioids for the 2 nd and strong opioids for the 3 rd step. Abstract: In this review we focus on the pathophysiology of CRC-related pain and discuss currently applied pain management. Pain is a symptom reported by over 70 % of colorectal cancer (CRC) patients. It remains a feared and debilitating consequence of both cancer and cancer-related treatment. There are many options for pain management in CRC, consisting of intravenous, oral or topical medications. In order to address the full spectrum of pain, proper treatment should address the nociceptive, neuropathic and/or psychogenic pain component. Currently available methods do not bring pain relief to satisfying number of patients and, if used improperly, can cause a number of complications. Therefore, future treatments should focus primarily on alleviating pain, but also on reducing possible side effects. In this article we cover recent and promising pharmacological and non- pharmacological developments emerging in the field of CRC treatment.