What are the clinical differences between radiation injury to the brachial plexus and tumor involvement of the plexus? Although clinically similar, radiation of the brachial plexus (nerve network that supplies innervation to upper extremity and shoulder extending from spinal cord to axilla) is more likely to cause involvement of all three trunks of the plexus, …
What is the most common site for tumor infiltration of the brachial plexus? The type of tumor will determine where infiltration is likely to occur, but most commonly the lower brachial plexus is involved, leading to pain and hand weakness in a C7 to T1 distribution. This is typically caused by a tumor located in …
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What is the postthoracotomy pain syndrome? The pain from thoracotomy encompasses the acute postoperative pain that resolves (usually within 3 months) and pain that persists longer than 3 months or recurs at the surgical site. The latter either is of neuropathic origin (as seen in postmastectomy axillary numbness) or may represent tumor recurrence. When pain …
Which neuropathic pain syndromes are commonly seen in patients with cancer? Lumbosacral plexopathy may be caused by lymphoma or colon cancer. Injury to the intercostobrachial nerve during radical mastectomy may result in pain or numbness distal to the axilla on the inner aspect of the arm. The neuropathy that develops from chemotherapy with cisplatin or …
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Is it common for patients with cancer to have more than one painful site? Yes, several large studies indicate that more than a quarter of patients with cancer report pain in more than one site. For example, a patient with lung cancer may experience chest wall pain (costochondritis) from the effort of breathing or coughing, …
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How does cancer treatment cause pain? The fact that treatment effects can themselves cause pain is well documented. Postoperative pain (e.g., surgical resection, postthoracotomy, or mastectomy chest wall pain) and acute amputation pain followed by “phantom” pain are common problems. Chemotherapeutic agents cause toxic side effects (e.g., chemotherapy-induced mucositis). Chemotherapeutic agents that can cause neuropathy …
How common is neuropathic pain in patients with cancer? Neuropathic pain has been estimated to occur in up to 90% of patients receiving chemotherapy with agents that are neurotoxic. It can also occur from tumor infiltration of neural structures or as a result of surgery or radiation-induced nerve damage. About one-third of patients with cancer …
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