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Record W4413877876 · doi:10.7759/cureus.91395

Understanding Cancer-Related Pain: Pathophysiology, Classification, and Treatment Modalities

2025· review· en· W4413877876 on OpenAlexaboutno aff
Jerish Murari, Ish Sharma, Siddharth Arjun Atwal, Sukanta Bandyopadhyay, B Shalini, Manish Kumar

Bibliographic record

VenueCureus · 2025
Typereview
Languageen
FieldMedicine
TopicPain Management and Opioid Use
Canadian institutionsnot available
FundersMicrosoft
KeywordsMedicinePathophysiologyModalitiesTreatment modalityCancer painCancerIntensive care medicinePathologyInternal medicine

Abstract

fetched live from OpenAlex

Cancer-related pain (CRP) is a complex, multidimensional challenge in oncology that undermines quality of life, psychological well-being, and treatment adherence. This narrative, mechanism-informed review synthesizes pathophysiology, classification systems, and multidisciplinary management strategies to provide clinical insights and research priorities. It connects nociceptive, neuropathic, and mixed pain mechanisms to practical interventions, emphasizing peripheral and central sensitization in chronicity. Major frameworks, including the WHO analgesic ladder, International Classification of Diseases, 11th Revision, Edmonton Classification System for Cancer Pain, and European Pain Federation standards, are appraised alongside assessment tools such as the Visual Analogue Scale, Brief Pain Inventory, and Hospital Anxiety and Depression Scale, with examples of their clinical application. Management is framed within a flexible, mechanism-based, multimodal model that integrates pharmacologic, adjuvant, interventional, and psychosocial approaches, delivered through coordinated, multidisciplinary teams. Evidence for complementary modalities, such as acupuncture and mindfulness-based stress reduction, remains preliminary and heterogeneous, requiring further high-quality trials, whereas opioid-based pharmacologic approaches and structured psychosocial interventions such as cognitive behavioral therapy are supported by more robust, established evidence. Similarly, innovations like AI-driven monitoring and pharmacogenomics hold promise but are still in the early validation phase, underscoring the need to distinguish between evolving and well-established domains of cancer pain management. The principal actionable priorities are to adopt mechanism-based classification, embed multidisciplinary collaboration, expand multimodal access in low-resource settings, and rigorously validate emerging pharmacogenomic and digital health innovations before widespread clinical integration.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame machine prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.

metaresearch head score (Codex)0.004
metaresearch head score (Gemma)0.010
Version: metacan-v3-hybrid-931329e0061cValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Not applicable · Consensus signal: none
GenreCandidate signal: Review · Consensus signal: Review
Teacher disagreement score0.004
Threshold uncertainty score0.024

Distilled classifier scores by category (both heads)

CategoryCodexGemma
Metaresearch0.0040.010
Meta-epidemiology (narrow)0.0010.000
Meta-epidemiology (broad)0.0020.002
Bibliometrics0.0030.002
Science and technology studies0.0010.002
Scholarly communication0.0040.003
Open science0.0010.001
Research integrity0.0010.003
Insufficient payload (model declined to judge)0.0020.001

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.221
GPT teacher head0.377
Teacher spread0.156 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designNot applicable
Domainnot available
GenreReview

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations1
Published2025
Admission routes1
Has abstractyes

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