Persistent pain in cancer survivors.

PURPOSE OF REVIEW: As people are living longer after a diagnosis and primary treatment for cancer, or indeed living with cancer as a chronic disease, new problems are emerging in this growing population of so-called 'survivors'. Persistent or chronic pain is one of the commonest complaints, arising from the tissue damage caused by the original neoplasm, consequences of surgery and other therapies, and - especially in older people - multimorbidity. This review explores some of the principle causes and mechanisms of this phenomenon and reviews the evidence for their management.

RECENT FINDINGS: We review recent findings regarding persistent pain in adults after surgery, chemotherapy (including targeted biological therapies), hormone manipulation and radiation therapy; and osteonecrosis from corticosteroid treatment in children with cancer. Recent research has revealed some of the molecular, genetic, phenotypic and psychological factors that predispose some people to developing more persistent pain after cancer, and their long-term outcomes.

SUMMARY: Although persistent pain in cancer patients surviving after primary treatment has been recognized for decades, only recently has research shown how this arises and some possible ways to intervene by prevention and interventions. New holistic models for management of persistent cancer-related pain are needed.