Understanding the Physiopathology of Pain Pathways for a Practical Approach of Cancer Pain Management.

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Pain associated with cancer is often the first symptom reported with major repercussions on patient's quality of life. Mechanical compression, release of algogenic substances by the tumor or the complications of oncologic treatment represent the major causes. Nociceptive and neuropathic pain are both induced by different mediators that give rise to a neuroinflammation creating a peripheral and central sensitization responsible of chronic pain. Understanding the pain pathway may orientate to the most appropriate treatment. Oral medication should be often reevaluated to consider multimodal analgesia including interventional pain procedures with intrathecal therapy and neuromodulation.