Treatment of neuropathic pain in cancer survivors: a scoping review of pharmacological, exercise, and psychosocial interventions.

Abstract

Background and purpose: Neuropathic pain is a debilitating late effect among cancer survivors. This scoping review aims to provide an overview of pharmacological, psychological, and exercise interventions for neuropathic pain among cancer survivors and to identify further relevant research areas. Patient/material and methods: PubMed, PsychInfo, and EMBASE were systematically searched for studies published from January 2004 to January 2026 and abstract and full text screening was carried out. The target population was cancer survivors who had completed primary treatment and have no active disease. Neuropathic pain was defined as a) a mean pain intensity the last week/month of ≥ 3 at a numerical rating scale (0 = no pain, 10 = worst pain), and b) symptoms of neuropathy, or c) neuropathic pain diagnosed by an experienced neurologist.

Results: Of the 956 systematic reviews/guidelines and 604 original studies identified, 11 pharmacological, two psychological and three studies on exercise were eligible. Most of the studies included patients with breast cancer. Duloxetine was effective in reducing neuropathic pain from painful chemotherapy-induced neuropathy and gabapentin + concomitant morphine compared to morphine alone reduced neuropathic pain in cancer survivors with neuropathic pain due to radiation therapy, and surgery. Mindfulness-based cognitive behavioral therapy showed no effect after correction for multiple comparisons. Exercise interventions were useful in both reducing neuropathic pain as well as neuropathic symptoms.

Interpretation: This scoping review found evidence for pharmacological treatment of neuropathic pain in cancer survivors, could not make any conclusion on psychological treatment, and exercise interventions show promising effects. Further research on interdisciplinary treatment of neuropathic pain among cancer survivors is needed.