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Cancer pain: molecular mechanisms and management
Wan-Li Wang1, Yi-Hang Hao1, Xin Pang2
1State Key Laboratory of Oral Diseases & National Clinical Research Center for Oral Diseases & Department of Oral and Maxillofacial Surgery, West China Hospital of Stomatology, Sichuan University, Chengdu, China.
Molecular Biomedicine
|June 27, 2025
Summary
Cancer pain management remains complex, with ongoing debates on mechanisms and treatments. This review explores neurobiology and advocates for multimodal, personalized strategies to improve patient care.
Area of Science:
- Oncology
- Pain Medicine
- Neuroscience
Background:
- Cancer pain significantly impacts patient quality of life and presents clinical challenges.
- Despite research and guidelines, controversies persist regarding cancer pain mechanisms and optimal management.
- Understanding the neurobiology is crucial for developing effective interventions.
Purpose of the Study:
- To systematically review the neurobiological underpinnings of cancer pain.
- To discuss current and emerging treatment strategies for cancer pain.
- To bridge mechanistic research with clinical practice for improved patient care.
Main Methods:
- Systematic review of literature on cancer pain neurobiology.
- Analysis of peripheral and central sensitization, cellular stress, signaling pathways, and epigenetic regulation.
- Evaluation of current pharmacological and non-pharmacological treatment approaches.
Main Results:
- Cancer pain involves complex interactions including sensitization, cellular dysfunction, signaling pathways, and epigenetics.
- A multimodal approach integrating pharmacological and non-pharmacological therapies is recommended.
- Debates continue regarding opioid rotation and long-term safety, highlighting the need for personalized therapies.
Conclusions:
- Refining guideline implementation and advancing targeted therapies are essential for improving cancer pain management.
- Standardized, interdisciplinary pain assessment tools are needed.
- This review provides a framework for precision oncology and holistic pain management.
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