Acute cancer pain syndromes

Abstract Cancer-related acute pain syndromes are most commonly due to diagnostic or therapeutic interventions and generally pose little diagnostic difficulty. Although some tumour-related pains have an acute onset (such as pain from a pathological fracture), most of these will persist unless effective treatment for the underlying lesion is provided. It is important to be familiar with these syndromes for several reasons: (1) when acute pain is anticipated, patients must be forewarned and steps undertaken to reduce the likelihood of distress, and if pain occurs, it requires an established therapeutic response. (2) Acute pain syndromes have variable natural histories which may influence management. This may be important in terms of pain prognosis (i.e. the anticipated time course of this problem). (3) Many of these syndromes have adverse effects and may be associated with a risk of substantial morbidity. It is important therefore to understand the significance of pain assessment and whether the pain may represent a substantial risk of harm or not. Finally, (4) there is often an important differential diagnosis with chronic pain syndromes associated with the underlying cancer.