Department of Oral & Maxillofacial, Pathology, Radiology & Medicine, New York University College of Dentistry, 345 East 24th Street, New York, NY 10010,
Med Oral Patol Oral Cir Bucal. 2016 Nov 1;21(6):e665-e671. doi: 10.4317/medoral.21515.
Cancer pain is a devastating condition. Pain in the orofacial region, may be present as the single symptom of cancer or as a symptom of cancer in its later stages. This manuscript revises in a comprehensive manner the content of the conference entitled "Orofacial Pain and Cancer" (Dolor Orofacial y Cancer) given at the VI Simposio International "Advances in Oral Cancer" on the 22 July, 2016 in San Sebastioan-Donostia, Spain.
We have reviewed (pubmed-medline) from the most relevant literature including reviews, systematic reviews and clinical cases, the significant and evidence-based mechanisms and mediators of cancer-associated facial pain, the diverse types of cancers that can be present in the craniofacial region locally or from distant sites that can refer to the orofacial region, cancer therapy that may induce pain in the orofacial region as well as discussed some of the new advancements in cancer pain therapy.
There is still a lack of understanding of cancer pain pathophysiology since depends of the intrinsic heterogeneity, type and anatomic location that the cancer may present, making more challenging the creation of better therapeutic options. Orofacial pain can arise from regional or distant tumor effects or as a consequence of cancer therapy.
The clinician needs to be aware that the pain may present the characteristics of any other orofacial pain disorder so a careful differential diagnosis needs to be given. Cancer pain diagnosis is made by exclusion and only can be reached after a thorough medical history, and all the common etiologies have been carefully investigated and ruled out. The current management tools are not optimal but there is hope for new, safer and effective therapies coming in the next years.
癌痛是一种极具破坏性的病症。口腔颌面部疼痛可能是癌症的唯一症状，也可能是癌症晚期的症状。本文全面修订了2016年7月22日在西班牙圣塞瓦斯蒂安 - 多诺斯亚举行的第六届国际“口腔癌进展”研讨会上题为“口腔颌面部疼痛与癌症”（Dolor Orofacial y Cancer）会议的内容。
我们检索了（pubmed - medline）最相关的文献，包括综述、系统评价和临床病例，以了解癌症相关面部疼痛的重要且基于证据的机制和介质、颅面部区域可能出现的各种局部或远处转移至口腔颌面部区域的癌症类型、可能导致口腔颌面部疼痛的癌症治疗方法，并讨论了癌症疼痛治疗的一些新进展。
由于癌症内在的异质性、类型和解剖位置，对癌痛病理生理学仍缺乏了解，这使得创建更好的治疗方案更具挑战性。口腔颌面部疼痛可能源于局部或远处肿瘤的影响，也可能是癌症治疗的结果。
临床医生需要意识到，这种疼痛可能具有任何其他口腔颌面部疼痛疾病的特征，因此需要进行仔细的鉴别诊断。癌痛的诊断是通过排除法做出的，只有在详细询问病史并仔细调查和排除所有常见病因后才能得出诊断。目前的治疗手段并不理想，但未来几年有望出现新的、更安全有效的治疗方法。
