A Cancer Pain Tutorial

A Comprehensive Visual Short Course
on Cancer Pain Management

Peripheral Neuropathy
animation of peripheral neuropathy
Pain Type : Nociceptive Neuropathic Psychogenic
Cause: Vinca Alkaloids (Vincristine), Cisplatin, and Procacarbazine
Effects: Painful Paraesthesia, Motor and Senory Loss

Clinical Signs:
Painful Sensarions, Usually Localized to Hands and Feet

The most common causative agents of peripheral neuropathy are the vinca alkaloids (vincristine), cisplatin, and procarbazine. The neuropathy is typically manifested by painful paresthesia and occasionally motor and sensory losses.

The painful sensations are usually localized to the hands and feet.

Steroid Pseudorheumatism

picture of steroid pseudorhematism

Steroid pseudorheumatism is caused by withdrawal of patients from corticosteroids. It is manifested by diffuse arthralgia check this and myalgia.

Pathophysiology of the pain is unknown.

Necrosis of Bone
necrosis of the bone-shoulder
necrosis of the bone - hip

Pain Type : Nociceptive Neuropathic Psychogenic
Cause: Chronic Steriod Therapy
Effects: Necrosis of Femoral and Humeral Heads
Clinical Signs:
Shoulder or Leg Exacerbated by Movement, Relieved by Rest
Diagnosis Bone Scans, Occasionally CT or MRI

Chronic steroid therapy can cause necrosis of the femoral and humeral heads. Clinical presentation is in the knee, shoulder, or leg, exacerbated by movement and relieved by rest.

Bone scans are the most sensitive diagnostic tool. Occasionally CT or MR scan can be useful in diagnosis.