Reflecting on Cancer Pain as Constant Acute Pain, not Chronic Pain. 'Known Knowns, Known Unknowns, Unknown Unknowns'.

IF 5 2区医学 Q1 ONCOLOGY

Current Oncology Reports Pub Date : 2025-05-01 Epub Date: 2025-04-03 DOI:10.1007/s11912-025-01642-w

Dympna Waldron, Kirk Levins, David Murphy, Michael McCarthy, David Gorey, Karen Ryan, Eileen Mannion, Bairbre Mc Nicholas, Doiminic Ó Brannagáin, Leona Reilly, Laura Gaffney, Beth Molony, Mary Healy, Jack Molony, Anthony Dickenson

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Abstract

Purpose of review: to explore a paradigm shift in the definition of opioid-responsive cancer pain in this hypothesis-driven review. Opioid-responsive cancer pain may be misplaced within the definition of chronic pain, chronic pain takes three months to establish, early effective control is worthwhile to achieve. RECENT: findings, from a bench-to-bed perspective, debates the interpretation of results supporting the hypothesis that opioid-responsive cancer pain could remain 'constant acute pain', with explanations, best solutions, for tolerance and/or addiction, in cancer patients compared to those with chronic pain from other conditions. Unraveling the unique apparent properties of opioid-responsive cancer pain empowers knowledge of the process by which acute pain may have the potential to remain acute in nature and not transition into chronic pain. Findings outlined defend the hypothesis of probable sustained acute nature of opioid-responsive cancer pain, importance of early, sustained pain control, opioid reduction and further exploration of this hypothesis in clinical practice.

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反思癌症疼痛是持续的急性疼痛，而不是慢性疼痛。“已知的已知，已知的未知，未知的未知”。

综述的目的：在这篇假设驱动的综述中，探讨阿片类药物反应性癌症疼痛定义的范式转变。阿片类药物反应性癌性疼痛可能在慢性疼痛的定义中错位，慢性疼痛需要三个月的时间才能建立，早期有效控制是值得实现的。最近的研究结果，从板凳到床的角度，讨论了支持阿片类药物反应性癌症疼痛可能保持“持续急性疼痛”的假设的结果的解释，与其他条件下的慢性疼痛相比，癌症患者的耐受性和/或成瘾性的解释，最佳解决方案。揭示阿片类药物反应性癌症疼痛的独特明显特性，使我们能够了解急性疼痛可能在本质上保持急性而不转变为慢性疼痛的过程。研究结果概述了阿片类药物反应性癌症疼痛可能持续急性的假设，早期、持续疼痛控制的重要性，阿片类药物的减少以及在临床实践中进一步探索这一假设。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Oncology Reports ONCOLOGY-

CiteScore

8.50

自引率

0.00%

发文量

187

审稿时长

6-12 weeks

期刊介绍： This journal aims to review the most important, recently published clinical findings in the field of oncology. By providing clear, insightful, balanced contributions by international experts, the journal intends to serve all those involved in the care of those affected by cancer. We accomplish this aim by appointing international authorities to serve as Section Editors in key subject areas, such as cancer prevention, leukemia, melanoma, neuro-oncology, and palliative medicine. Section Editors, in turn, select topics for which leading experts contribute comprehensive review articles that emphasize new developments and recently published papers of major importance, highlighted by annotated reference lists. An international Editorial Board reviews the annual table of contents, suggests articles of special interest to their country/region, and ensures that topics are current and include emerging research. Commentaries from well-known figures in the field are also provided.