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
pain generation and maintenance. The changes in the
dorsal horn therefore need to be targeted to relieve
pain and prevent pain recurrence.16