Joan M. Regan, MB, BCh, FFARCSI, and Philip Peng, MBBS, FRCPC, Toronto Western Hospital, University Health Network, Toronto, Canada

Abstract and Introduction
Abstract
Background:Recent basic science research has greatly added to our knowledge of pain mechanisms. Application of this knowledge to cancer pain syndromes has led to new and innovative approaches to cancer pain management.
Methods:The mechanisms involved in the three main cancer pain syndromes (somatic, visceral, and neuropathic) are reviewed, and various therapeutic options are discussed.

Results: Advances in knowledge in neurophysiology, neuroanatomy, and pharmacology have allowed a greater understanding of the peripheral and central mechanisms of pain. New drugs and interventionaltechniques based on this knowledge have improved the control of cancer pain.

Conclusions: Understanding the neurophysiology of cancer pain promotes use of the most appropriatepalliative measures for pain control.

Introduction
It is estimated that 70% to 90% of patients withadvanced cancer experience significant pain. Sinceuncontrolled pain can have an adverse impact onpatients and their families, optimal management ofpain should be a priority goal for all clinicians.^[1-3]

Cancer pain syndromes can be classified as somatic,visceral, or neuropathic in origin. Pain may be due totumor infiltration of local structures or to antineoplastictherapy, or it may be unrelated to the tumor.^[2] Recognitionof pain syndromes is essential for the adequatemanagement of cancer pain. Basic science research onthe mechanisms of pain has been helpful in providingthe scientific rationale for new approaches to cancerpain management. This article reviews the neurophysiology of pain, with an emphasis on the understandingand treatment of cancer pain syndromes.

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Cancer Control 7(2):111-119, 2000. © 2000 H. Lee Moffitt Cancer Center and Research Institute, Inc