Chronic Pain in the Cancer Survivor

As cancer survivorship continues to rise, attention has increasingly turned to the long-term sequelae of oncologic treatment. While interventions such as chemotherapy, radiation therapy, and surgery have significantly improved survival outcomes, they are frequently associated with chronic pain syndromes that can profoundly impact quality of life. This review synthesizes current evidence and therapeutic approaches for three prevalent pain conditions in cancer survivors: chemotherapy-induced peripheral neuropathy, post-radiation pain syndromes, and post-surgical pain syndromes. Emphasis is placed on pathophysiology, diagnostic considerations, and emerging management strategies to guide clinicians in optimizing survivorship care.

Evidence supports the use of duloxetine for chemotherapy-induced peripheral neuropathy. Despite the wide use of gabapentinoids and tricyclic antidepressants for chemotherapy-induced peripheral neuropathy the data is limited on efficacy. For post-radiation and post-surgical pain syndromes related to cancer, current evidence supports a multimodal approach of physical therapy, injections, and pharmacologic agents. A personalized and multimodal approach is recommended for chronic pain in cancer survivors. Further investigations into the treatment for chronic pain syndromes in cancer survivors are critical to improve the long-term outcomes and quality of life for cancer survivors.