Cancer-Associated Neuropathic Pain and Paraneoplastic Syndromes

Abstract

While somatic pain due to cancer infiltration of the tissues is the most common type of cancer pain, neuropathic pain is also common among patients with cancer and is often refractory to standard opioid and pain medications. We will focus on cancer-associated neuropathic pain in this chapter. Conceptually, cancer-associated neuropathic pain can occur due to the direct infiltrative effect of the cancer itself or can be due indirectly to adverse effects of treatment or the presence of a paraneoplastic syndrome (Table 14.1). Of the treatment-induced neuropathies, those due to chemotherapy are most common and will be discussed in detail below. This would be followed by a discussion of radiation-induced plexopathies and, finally, paraneoplastic syndromes. Neuropathies asso-ciated with monoclonal gammopathies, amyloid neuropathies, and toxic neuropathies (besides chemotherapy-induced neuropathies) are covered elsewhere in this book (Chapters 13, 16, and 24).