Pathophysiology
Cancer cells and the subsequent effects of tissue damage
cause the production of noxious substances which
stimulate the peripheral nerve endings of the C and
A-delta primary afferent fibers. Stimulation of these
fibers results in the lowering of activation thresholds,
the recruitment of quiescent nociceptors, and the activation
of NMDA-receptor-channel complex leading
to dorsal horn sensitization. This process results in
Clinical management of pain in advanced lung cancer
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pain generation and maintenance. The changes in the
dorsal horn therefore need to be targeted to relieve
pain and prevent pain recurrence.16