Management of neuropathic pain following treatment for breast cancer in the absence of recurrence: a challenge for the radiation oncologist.
This report reviews various management options for treatment-induced neuropathic pain in breast cancer. First-line options include tricyclic antidepressants and anticonvulsant drugs. Opioids should be prescribed according to published guidelines. Second-line treatments include lignocaine, mexiletine and ketamine. Sympatholytic therapies are available to patients with features of chronic regional pain syndrome. Anti-inflammatory agents are used for neurogenic inflammation. Surgical interventions are considered for refractory neuropathic pain. Interdisciplinary management is appropriate when persisting pain causes physical and psychosocial disabilities.
Clubb
B
B
Pain Management Clinic, The Canberra Hospital, Canberra, Australian Capital Territory, Australia. bryce.clubb@act.gov.au
D000701:Analgesics, Opioid / Q000627:therapeutic use; D000777:Anesthetics / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000627:therapeutic use; D001943:Breast Neoplasms / Q000532:radiotherapy*; D005260:Female; D006801:Humans; D009407:Nerve Block; D009422:Nervous System Diseases / Q000188:drug therapy* / Q000209:etiology; D010146:Pain / Q000188:drug therapy* / Q000209:etiology; D013565:Sympatholytics / Q000627:therapeutic use
D000701:Analgesics, Opioid; D000777:Anesthetics; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000927:Anticonvulsants; D000929:Antidepressive Agents, Tricyclic; D013565:Sympatholytics