title: Acidosis and Formaldehyde Secretion as a Possible Pathway of Cancer Pain and Options for Improved Cancer Pain Control.
abstract: The prevalence of cancer pain in patients with cancer is high. The majority of efforts are spent on research in cancer treatment, but only a small fraction focuses on cancer pain. Pain in cancer patients, viewed predominantly as a secondary issue, is considered to be due to the destruction of tissues, compression of the nerves, inflammation, and secretion of biological mediators from the necrotic tumor mass. As a result, opioid drugs have remained as the primary pharmacological therapy for cancer pain for the past hundred years. This report reviews evidence that cancer pain may be produced by the metabolic effects of two byproducts of cancer-high acidity in the cancer microenvironment and the secretion of formaldehyde and its metabolites. We propose the research and development of therapeutic approaches for preemptive, short- and long-term management of cancer pain using available drugs or nutraceutical agents that can suppress or neutralize lactic acid production in combination with formaldehyde scavengers. We believe this approach may not only improve cancer pain control but may also enhance the quality of life for patients.
authors.forename: Ba X
authors.initials: BX
authors.lastname: Hoang
authors.forename: D Graeme
authors.initials: DG
authors.lastname: Shaw
authors.forename: Bo
authors.initials: B
authors.lastname: Han
authors.forename: Josephine Y
authors.initials: JY
authors.lastname: Fang
authors.forename: Marcel
authors.initials: M
authors.lastname: Nimni
mesh_terms: D000138:Acidosis / Q000188:drug therapy*; D000444:Aldehyde Dehydrogenase / Q000096:biosynthesis; D003999:Dichloroacetic Acid / Q000493:pharmacokinetics; D005557:Formaldehyde / Q000378:metabolism*; D005978:Glutathione / Q000494:pharmacology; D006801:Humans; D006863:Hydrogen-Ion Concentration; D019344:Lactic Acid / Q000378:metabolism; D009369:Neoplasms / Q000150:complications*; D010146:Pain / Q000188:drug therapy* / Q000209:etiology* / Q000503:physiopathology; D059408:Pain Management / Q000379:methods; D011788:Quality of Life; D000077185:Resveratrol; D017693:Sodium Bicarbonate / Q000494:pharmacology; D013267:Stilbenes / Q000493:pharmacokinetics
chemical_list: D013267:Stilbenes; D005557:Formaldehyde; D019344:Lactic Acid; D017693:Sodium Bicarbonate; D003999:Dichloroacetic Acid; D000444:Aldehyde Dehydrogenase; D005978:Glutathione; D000077185:Resveratrol
keywords: DCA; acidosis; cancer; formaldehyde; lactic acid; pain; sodium bicarbonate