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Radiotherapy-Specific Chronic Pain Syndromes in the Cancer Population: An Evidence-Based Narrative Review

Advances in Therapy volume 38, pages 1425–1446 (2021)Cite this article

Abstract

While radiation therapy is increasingly utilized in the treatment paradigm of many solid cancers, the chronic effects of radiation therapies are poorly characterized. Notably, understanding radiation-specific chronic pain syndromes is paramount given that the diagnosis and management of these conditions can serve to prevent long-standing functional impairments, optimize quality of life, and even allow for continued radiotherapy candidacy. These radiation-specific chronic pain phenomena include dermatitis, mucositis, enteritis, connective tissue fibrosis, lymphedema, and neuropathic pain syndromes. It is necessary to maintain a low threshold of suspicion for appropriately diagnosing these conditions as there exists a variance in when these symptoms arise after radiation. However, we present key epidemiological data delineating vulnerable cancer populations for each pain syndrome along with the available evidence for the management for each specific condition.

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Acknowledgements

Funding

No funding or sponsorship was received for this study or publication of this article

Authorship

All named authors meet the International Committee of Medical Journal Editors (ICMJE) criteria for authorship for this article, take responsibility for the integrity of the work as a whole, and have given their approval for this version to be published.

Disclosures

Amitabh Gulati is a consultant for SPR Therapeutics, Nalu Medical, Medtronic, AIS Healthcare, Bausch Health. Alaa Abd-Elsayed is a consultant for Medtronic, StimWave, and Avanos. Jay Karri, Laura Lachman, Alex Hanania, Anuj Marathe, Mani Singh, Nicholas Zacharias and Vwaire Orhurhu declare they have nothing to disclose.

Compliance with Ethics Guidelines

This article is based on previously conducted studies and does not contain any new studies with human participants or animals performed by any of the authors.

Data Availability

Data sharing is not applicable to this article as no datasets were generated or analyzed during the current study.

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Authors and Affiliations

  1. Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Jay Karri, Laura Lachman & Anuj Marathe

  2. Department of Radiation Oncology, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX, USA

    Alex Hanania

  3. Department of Rehabilitation and Regenerative Medicine, Columbia University College of Physicians and Surgeons, New York City, NY, USA

    Mani Singh

  4. Division of Pain Medicine, Department of Anesthesia, School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA

    Nicholas Zacharias & Alaa Abd-Elsayed

  5. Division of Pain Medicine, Department of Anesthesia, University of Pittsburgh Medical Center, Susquehanna, Williamsport, PA, USA

    Vwaire Orhurhu

  6. Division of Pain Medicine, Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York City, NY, USA

    Amitabh Gulati

Authors
  1. Jay Karri
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  2. Laura Lachman
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  3. Alex Hanania
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  4. Anuj Marathe
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  5. Mani Singh
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  6. Nicholas Zacharias
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  7. Vwaire Orhurhu
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  8. Amitabh Gulati
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  9. Alaa Abd-Elsayed
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Corresponding author

Correspondence to Alaa Abd-Elsayed.

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Karri, J., Lachman, L., Hanania, A. et al. Radiotherapy-Specific Chronic Pain Syndromes in the Cancer Population: An Evidence-Based Narrative Review. Adv Ther 38, 1425–1446 (2021). https://doi.org/10.1007/s12325-021-01640-x

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  • DOI: https://doi.org/10.1007/s12325-021-01640-x

Keywords

  • Cancer
  • Chronic pain
  • Multidisciplinary pain management
  • Radiotherapy