Mechanisms of, and Adjuvants for, Bone Pain

Publication date: Available online 22 March 2018
Source:Hematology/Oncology Clinics of North America
Author(s): Nicholas Figura, Joshua Smith, Hsiang-Hsuan Michael Yu

Teaser

Metastatic bone pain is a complex, poorly understood process. Understanding the unique mechanisms causing cancer-induced bone pain may lead to potential therapeutic targets. This article discusses the effects of osteoclast overstimulation within the tumor microenvironment; the role of inflammatory factors at the tumor-nociceptor interface; the development of structural instability, causing mechanical nerve damage; and, ultimately, the neuroplastic changes in the setting of sustained pain. Several adjuvant therapies are available to attenuate metastatic bone pain. This article discusses the role of pharmacologic therapies, surgery, kyphoplasty, vertebroplasty, and radiofrequency ablation.


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