Classification of Pain for Patient with Cancer

 

Pain associated with tumor invasion or extension:

(1) infiltration or compression of a peripheral nerve

(2) radiculopathy or cauda equina syndrome

(3) infiltration or compression of a nerve plexus (cervical, brachial, lumbosacral, sacral)

(4) myelopathy

(5) bone involvement

(5a) metastases to bone

(5b) pathologic fracture

(5c) primary bone involvement

(6) soft tissue involvement

(6a) skin and subcutaneous tissue

(6b) muscle and fascia

(7) visceral involvement

(7a) esophageal or mediastinal pain

(7b) referred shoulder pain from invasion of diaphragm

(7c) distention of organ capsule (liver, other)

(7d) suprapubic from bladder or pelvic organ

(7e) perineal

(7f) mucosal surface (oral, rectal, etc)

(7g) epigastric

(8) obstruction

(8a) biliary system

(8b) bowel

(8c) ureter or urethra

(9) diffuse peritoneal involvement

(10) diffuse pleural involvement

(11) retroperitoneal involvement

(12) headache from raised intracranial pressure or intracranial disease

(13) headache, neck or back pain from involvement of leptomeninges

(14) involvement of structures in the head and neck (base of the skull, jugular foramen, sphenoid sinus, etc)

(15) infiltration of joint or joint capsule

(16) paraneoplastic neurologic disorder

 

Pain following surgery:

(1) acute postoperative pain

(2) chronic (post-mastectomy, post-thoracotomy, post-nephrectomy, post-amputation, etc)

(3) stent placement

 

Pain following chemotherapy:

(1) peripheral neuropathy

(2) pseudorheumatism (associated with corticosteroid therapy)

(3) aseptic necrosis of bone

(4) mucositis, cystitis or enteritis

(5) chemoembolization

(6) aseptic meningitis

(7) myositis

 

Pain following radiation therapy:

(1) fibrosis about a nerve plexus

(2) fibrosis entrapping a peripheral nerve

(3) radiation myelopathy

(4) radiation-induced nerve tumor

(5) mucositis, enteritis, proctitis or cystitis

(6) acute bone pain from tumor swelling

(7) osteonecrosis

(8) radiation dermatitis

 

Other pain:

(1) post-herpetic neuralgia