Analysis and treatment of different types of neuropathic cancer pain.

Neuropathic pain is a major problem in the treatment of cancer pain. We performed a retrospective analysis of 213 cancer patients with neuropathic pain treated by a pain service following the World Health Organization guidelines for relief of cancer pain. Of these, 79% presented with nerve compression pain, 16% with nerve injury pain, and 5% with sympathetically-maintained pain. Whereas nerve compression and nerve injury pain were caused most frequently by cancer growth, sympathetically-maintained pain was caused most frequently by cancer treatment. There were no significant differences in the use of analgesics, the mean pain intensity, or the efficacy of analgesic treatment among the three groups. Nerve injury pain and sympathetically-maintained pain were treated more frequently with adjuvant analgesics, especially antidepressants and anticonvulsants. The variety of different neuropathic pain syndromes should be separated in future studies of the efficacy of different treatment approaches.