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The Tumor Microenvironment02:17

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Every normal cell or tissue is embedded in a complex local environment called stroma, consisting of different cell types, a basal membrane, and blood vessels. As normal cells mutate and develop into cancer cells, their local environment also changes to allow cancer progression. The tumor microenvironment (TME) consists of a complex cellular matrix of stromal cells and the developing tumor. The cross-talk between cancer cells and surrounding stromal cells is critical to disrupt normal tissue...
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Immunotherapy is a treatment that boosts or manipulates the immune system to fight diseases, including cancer. For instance, by stimulating an immune response through vaccinations against viruses that cause cancers, like hepatitis B virus and human papillomavirus, these diseases can be prevented. Nonetheless, some cancer cells can avoid the immune system due to their rapid mutation and division. The immune response to many cancers involves three phases: elimination, equilibrium, and escape.
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Cancers arise due to mutations in genes involved in the regulation of cell division, which leads to unrestricted cell proliferation. Modern science and medicine have made great strides in the understanding and treatment of cancer, including eradicating cancer in some patients. However, there is still no cure for cancer. This is largely due to the fact that cancer is a large group of many diseases.
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[Tumor-associated pain].

Stefan Wirz1, Jens Keßler2, Hannes Hofbauer3

  • 1Abteilung für Anästhesie, Interdisziplinäre Intensivmedizin, Schmerzmedizin/Palliativmedizin - Zentrum für Schmerzmedizin, Weaningzentrum, Cura Krankenhaus - eine Betriebsstätte der GFO Kliniken Bonn, Schülgenstr. 15, 53604, Bad Honnef, Deutschland. stefan.wirz@gfo-kliniken-bonn.de.

Schmerz (Berlin, Germany)
|January 11, 2024
PubMed
Summary
This summary is machine-generated.

Managing tumor-associated pain requires a tailored, multimodal approach. Integrating pain type analysis, customized World Health Organization (WHO) guidelines, and palliative care improves patient outcomes.

Keywords:
Breakthrough painCancer pain/drug therapyCancer pain/interventional therapyChronic painPersistent pain

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Area of Science:

  • Oncology
  • Pain Medicine
  • Palliative Care

Context:

  • Tumor-associated pain is prevalent and challenging.
  • Treatment side effects often complicate cancer pain.
  • Pain arises from both the cancer and its treatment.

Purpose:

  • To outline a pathophysiologically oriented approach for tailored cancer pain treatment.
  • To adapt the World Health Organization (WHO) analgesic ladder for cancer pain.
  • To emphasize multimodal strategies for chronic tumor-associated pain.

Summary:

  • A pathophysiological analysis (nociceptive, nociplastic, neuropathic) guides tailored cancer pain management.
  • Customize the WHO analgesic ladder with antineuropathic/antihypersensitizing drugs and minimally invasive techniques.
  • Incorporate psycho-oncology and exercise therapy.
  • Chronic pain requires multimodal approaches similar to non-cancer pain.
  • Integrate palliative medicine for seamless care transitions.

Impact:

  • Improved pain management strategies for cancer patients.
  • Enhanced therapeutic effectiveness through integrated palliative care.
  • Better quality of life for individuals experiencing tumor-associated pain.