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Comprehensive antigen profiling predicts post-surgical neuropathic pain in women treated for breast cancer.

The importance of neuroimmune interactions in neuropathic pain (NP) has been established, but antibody-mediated mechanisms remain underexplored. In this explorative case-control study, we analyzed antibody profiles in patients with intercostobrachial nerve injury during breast cancer (BC) surgery. We compared 27 patients who developed chronic NP with 30 who remained NP-free, despite similar nerve injury. Plasma samples were collected before surgery and 4–9 years later. Mimotope variation analysis (MVA), a next generation random peptide phage display method revealed highly individual yet shared

Radiotherapy-Associated Pain in Head and Neck Cancer: From Clinical Burden to Neuroimmune Modulator.

Radiotherapy-associated pain is among the most common and debilitating complications in head and neck cancer. Although historically viewed primarily as a treatment-related adverse effect, growing evidence suggests that pain is deeply intertwined with tumor biology, immune remodeling, and therapeutic outcomes. At the same time, recent advances in cancer neuroscience have identified sensory nerves as active components of the tumor microenvironment (TME), capable of influencing antitumor immunity through complex neuroimmune crosstalk. These observations raise the possibility that radiotherapy-ass

Functional brain connectivity correlates of pain relief during virtual reality exposure in cancer patients.

INTRODUCTION: Virtual reality (VR) has shown promise for pain relief, including in cancer-related contexts, yet its underlying neurophysiological correlates remain unclear. Understanding brain-based correlates is important for evaluating VR programs and informing personalized pain management. Functional connectivity reflects coordinated activity among pain-related brain regions. METHODS: This study examined associations between changes in functional connectivity and pain reduction during VR exposure using functional near-infrared spectroscopy (fNIRS) in cancer patients with chronic neuropathi

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… The cancer pain experienced by participants in this study comprised neuropathic and/or somatic components, reflecting mixed-mechanism chronic pain ( 28 , 29 ). … Overcoming barriers to cancer pain management: an institutional change model. J Pain Symptom Manage. (2007) 34:359–69. 10.1016/j.jpainsymman.2006.12.011 21. Stokefarm Productions. Oceania VR. Directed by James Donald. …

Fumaric acid regulates morphine tolerance in bone cancer pain through spinal MrgC receptor modulation.

BACKGROUND: Bone cancer pain (BCP) represents a debilitating complication that profoundly impacts patient quality of life and predisposes to psychological comorbidities, including depression and anxiety. OBJECTIVES: To investigate the effect of fumaric acid on morphine tolerance in BCP via spinal MrgC receptors. METHODS: This study adopted an in-vivo animal experiment design. The BCP mouse model was established and divided into the Vehicle group, the fumaric acid monotherapy group with different doses, the fumaric acid + morphine combination group, the normal saline + morphine control group …

Tumor-nerve crosstalk: peripheral mechanisms mediating bone tumor progression and cancer-induced bone pain.

Cancer-induced bone pain (CIBP) is one of the most debilitating complications of primary bone tumors and bone metastases. Traditionally regarded as a consequence of bone destruction and mechanical compression, CIBP is now recognized as a complex pathological process involving dynamic interactions among tumor cells, peripheral nerves, immune cells, and the bone microenvironment. Increasing evidence indicates that tumor-nerve crosstalk contributes not only to nociceptive sensitization and neural remodeling but also to tumor progression and immune regulation. In the bone tumor microenvironment, t

Cancer survivors living with chronic pain: patient and healthcare professional perspectives and current recommendations.

PURPOSE OF REVIEW: Chronic pain affects approximately 40% of cancer survivors and remains an under recognized and complex condition. This review is timely given the growing population of cancer survivors and the persistent gaps in evidence-based guidance for managing chronic post-cancer treatment pain. It synthesizes recent research (primarily since 2024) to inform clinical practice and future guideline development. RECENT FINDINGS: Three key themes emerged: inadequate pain assessment and communication, compounded by negative clinical and societal attitudes; opioid stigma and uncertainty rega

METTL3 modulates bone Cancer pain via m6A-dependent JAK2/STAT3 activation in spinal astrocytes.

N6-methyladenosine (m6A) is primarily associated with extensive changes in epigenetic regulation in eukaryotic organisms, particularly facilitated by the Methyltransferase-like 3 (METTL3) enzyme in cancer and inflammatory pain. However, the pathways through which METTL3 mediates these conditions remain largely unknown. This study elucidates the pathways by which m6A methylation of JAK2 mRNA by METTL3 occurs within astrocytes in the spinal cord, thereby facilitating continuous JAK2 mRNA translation. In bone cancer pain (BCP) mice, the upregulation of TNF-α and IL-1β aggravates pain sensation. F…

Electroacupuncture therapy and bone cancer pain relief: experimental study on analgesic mechanisms in rats.

BACKGROUND: Bone cancer pain is a common complication of advanced malignant tumors.Chemotherapeutic drugs, regardless of their origin or type, are often associated with various adverse effects such as gastrointestinal toxicity, immune suppression, and acquired drug resistance, which can compromise patients' quality of life and treatment compliance. Electroacupuncture, known for its safety and analgesic effects, has been increasingly studied in bone cancer pain but the underlying mechanism is not fully understood. OBJECTIVE: To explore the mechanism of electroacupuncture in rats with bone canc…

When Obesity Meets Lymphedema: Interaction Effects on Lymphatic Pain Among Chinese Breast Cancer Survivors.

BACKGROUND: Lymphatic pain is an underrecognized symptom among breast cancer survivors and may indicate early lymphatic dysfunction. This study examined the prevalence of lymphatic pain and its associated factors, with a particular focus on the interaction between obesity and breast cancer-related lymphedema (BCRL). METHODS: A secondary analysis was conducted using datasets from 2 previously completed studies. 894 participants who completed arm circumference measurements and symptom assessments were included. Independent t-tests, chi-square tests, Fisher's exact tests, and binary logistic reg

Bibliometric and visual analysis of digital healthcare in cancer pain management via mobile apps.

BACKGROUND: Cancer pain is a common symptom among cancer patients, and although opioid drugs are effective, they have side effects and abuse issues. In recent years, mobile apps have gradually been used as digital healthcare for cancer pain management. By visualizing and analyzing the literature on the control of cancer pain through mobile apps, we aim to understand the current research status and hot issues in this field and explore future directions for digital smart healthcare research. METHODS: CiteSpace software was used to visually analyze 252 articles on mobile app-based cancer pain co…

Machine learning predicting acute pain and opioid dose in radiation treated oropharyngeal cancer patients.

INTRODUCTION: Acute pain is common among oral cavity/oropharyngeal cancer (OCC/OPC) patients undergoing radiation therapy (RT). This study aimed to predict acute pain severity and opioid doses during RT using machine learning (ML), facilitating risk-stratification models for clinical trials. METHODS: A retrospective study examined 900 OCC/OPC patients treated with RT during 2017-2023. Pain intensity was assessed using NRS (0-none, 10-worst) and total opioid doses were calculated using morphine equivalent daily dose (MEDD) conversion factors. Analgesics efficacy was assessed using combined pai

Role of Implantable Intrathecal Pumps in Refractory Cancer Pain: Systematic Review and Meta-Analysis.

BACKGROUND: Despite advances in systemic analgesic strategies for cancer patients suffering pain, a subset of patients remains unresponsive to standard treatment. Intrathecal infusion therapy offers targeted pain relief, with implantable pumps being particularly beneficial for those with longer life expectancies. Although recommended in clinical guidelines, implantable pumps remain underused. To support informed clinical decision-making, we conducted a systematic review and meta-analysis to evaluate the efficacy of this therapy in reducing refractory cancer-related pain. METHODS: This systema

GPR37 Activation Alleviates Bone Cancer Pain via the Inhibition of Osteoclastogenesis and Neuronal Hyperexcitability.

Osteolytic bone cancer pain is a primary concern for cancer patients with bone metastasis, and current therapies offer inadequate pain relief. The present study demonstrates that activation of the G protein-coupled receptor 37 (GPR37) by neuroprotectin D1 (NPD1) or artesunate (ARU) alleviates both acute and persistent pain in multiple mouse models of bone cancer. GPR37 agonists also protect against cancer-induced bone destruction. Mechanistically, NPD1 or ARU binding to GPR37 in macrophages promotes the release of IL-10, which further inhibits cancer-induced osteoclastogenesis. Moreover, direc…

Commonly used interventional procedures for non-cancer chronic spine pain: a clinical practice guideline.

CLINICAL QUESTION: What is the comparative effectiveness and safety of commonly used interventional procedures (such as spinal injections and ablation procedures) for chronic axial and radicular spine pain that is not associated with cancer or inflammatory arthropathy? CURRENT PRACTICE: Chronic spine pain is a common, potentially disabling complaint, for which clinicians often administer interventional procedures. However, clinical practice guidelines provide inconsistent recommendations for their use. RECOMMENDATIONS: For people living with chronic axial spine pain (≥3 months), the guidelin

Chemical neurolysis of genicular nerves for chronic non-cancer knee pain: a scoping review.

OBJECTIVE: Chemical neurolysis of the genicular nerves is a treatment option for intractable non-cancer knee pain. This scoping review synthesizes the available literature on the effectiveness, adverse events, and procedural techniques of chemical neurolysis of genicular nerves for the management of knee pain. DESIGN: Scoping review. SETTING: All clinical and research settings. SUBJECTS: Adult participants with chronic non-cancer knee pain undergoing chemical neurolysis of genicular nerves. METHODS: A literature search in MEDLINE, EMBASE, and Cochrane Library was conducted up to September

Relationship between pain and nonopioid substance use in two national samples of cancer survivors.

SIGNIFICANCE: Pain and nonopioid substance use (tobacco, cannabis, alcohol) frequently co-occur, but have been understudied among cancer survivors. Even less work has examined whether pain and nonopioid substance use is related to other cancer treatment-related side effects, mental health, and health-related quality of life. METHODS: Two national datasets were used to assess a range of variables and confirm patterns. Study 1 included 1252 adults (88% White; 55% female; 60% aged ≥65) from Wave 6 (2021) of the Population Assessment of Tobacco and Health Study, and Study 2 included 4130 adults (

Empowering Cancer Patients with Self-Care and Pain Management Skills: A Quasi-Experimental Study.

BACKGROUND: Cancer patients experience distress as a result of their health condition, which, in turn, contributes to the progression of the disease. Moreover, their daily activities, well-being, and health status are significantly impacted by pain and other symptoms. In this context, empowering these patients with self-care and pain management skills can greatly contribute to effective symptom control. AIM: To develop and implement an educational approach focused on empowering family caregivers and patients with advanced cancer in effectively managing pain at home. METHOD: An educational pr

Differences in Inpatient Management of Cancer-Related Pain Among Patients with Opioid Use Disorder.

The management of cancer-related pain in patients with opioid use disorder (OUD) remains complex and often challenging for clinicians and patients. There is currently a paucity of data to guide best practices, and the evidence that exists is variably applied. In this hospital-based questionnaire, we sought to understand the variation in practice patterns among clinicians in palliative medicine, addiction medicine, and hospital medicine, in caring for this complex patient population. Sixty-two questionnaire responses were analyzed and variation was found in management of pain, as well as initia

Ganglion Impar Neurolysis to Treat Refractory Chronic Pain From Vulvar Cancer: A Case Report.

Cancer pain treatment currently consists of the administration of pain medications, radiation therapy, tumor ablation as well as neurolytic plexus blocks. Neurolytic plexus blocks target both sensory afferent fibers and sympathetic fibers innervating visceral organs. Finding the right block for a specific type and location of cancer-related pain is crucial for the successful control of pain. One such example is a ganglion impar block for perineal pain. We report a case of a patient with chronic severe perineal pain from vulvar cancer and multiple surgeries, for whom a ganglion impar block foll…