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CANCER PAIN: CAUSES-PAIN ASSOCIATED WITH TREATMENT, PAIN RELATED TO DEBILITATING DISEASE AND PAIN UNRELATED TO CANCER OR TREATMENT
Diagnostic and staging procedures, surgery, chemotherapy and radiotherapy may all cause pain.
Painful neuropathy may occur after any surgical procedure but most frequently follows thoracotomy, neck dissection or mastectomy. Patients undergoing amputation can develop pain in the stump or in the phantom limb.
Radiotherapy can cause painful inflammation of any mucous membranes treated. Painful neuropathy may develop months or years after irradiation of the brachial or lumbosacral plexus; painful myelopathy may occur after treatment of the spinal cord.
Pain related to debilitating disease-A small proportion of pain experienced by patients with advanced cancer relates directly to the effects of debilitating disease.
Myofascial pain originates from a muscle and its surrounding fascia and is characterised by a localised tender point (trigger point), stimulation of which produces local pain that radiates in a non-dermatomal manner. Myofascial pain is common in the general population and occurs more frequently in patients with cancer who are debilitated or cachectic.
Pain unrelated to cancer or treatment-A small proportion of pains reported by patients with cancer are unrelated to the cancer or its therapy. Most frequently encountered are the various forms of arthritis and pain due to ischaemic heart disease and peripheral vascular disease.
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