Neurophysiological Mechanisms Related To Pain Management In Bone Tumors

Background: Primary and metastatic bone tumor incidence has increased in the last years. Pain is a common symptom and is one of the most important related factor to the decrease of quality of life in these patients. Different pain management strategies are not completely effective and many patients afflicted by cancer pain cannot be controlled properly. In this sense we need to elucidate the neurophysiology of cancer-induced pain contemplating other quality of life components such as inflammation, neuropathies and cognitive components regarding bone tumors, and thus pave the way for novel therapeutic approaches in this field.Aim: Identify the neurophysiology of the mechanisms related to pain management in bone tumors.Method: Advanced searches were performed in scientific databases: PubMed, ProQuest, EBSCO, and the Science Citation index to get information about the neurophysiology mechanisms related to pain management in bone tumors.Results: The central and peripheral mechanisms that promote bone cancer pain are poorly understood. Studies have shown that bone cancer could be related to neurochemicals produced by tumor and inflammatory cells, coupled with peripheral sensitization due to nerve compression and injury caused by tumor growth. Activity of mesolimbic dopaminergic neurons, substance P, cysteine/glutamate antiporter, and other neurochemical dynamic's brings us putative strategies to suggest better and efficient treatments against pain in cancer patients.Conclusion: Cancer-induced bone pain could include neuropathic and inflammatory pain, but with different modifications to the periphery tissue, nerves and neurochemical changes in different neurological levels. In this sense, here we explore opportunity areas in pharmacological and non-pharmacological pain management, according to pain-involved mechanisms.