bims-netuvo Biomed News
on Nerves in tumours of visceral organs
Issue of 2021‒09‒26
three papers selected by
Maksym V. Kopanitsa
The Francis Crick Institute

  1. Cancer Treat Res. 2021 ;182 203-223
      Peripheral nerve entrapments can occur anywhere in the head and body and can cause significant pain. Cancer pain can be caused by these entrapments, triggered by a variety of etiologies, including tumor invasion, surgical trauma, chemotherapy, or scarring. Knowing the cause of pain can help the physician treat the problem effectively, and will decrease unnecessary and potentially worsening surgeries and high dose opioid therapies, as well as unnecessary pain. A knowledgeable interventional pain physician can diagnose and treat these nerves entrapments in the most effective manner, providing improved pain relief and quality of life.Key points Nerve entrapments can occur throughout the body in cancer patients due to multiple etiologies such as tumor invasion, surgical trauma, or cancer therapy. The problem of nerve entrapments in cancer pain is under-recognized. Patients with nerve entrapment syndromes frequently complain of a burning tingling sensation and other paresthesias in the nerve distribution which can progress to a complete loss of sensory and motor function. Diagnostic tools include history and physical exam, imaging, nerve conduction studies as well as diagnostic nerve injections/blocks. Treatment of nerve entrapments can range from neuropathic pain medications to nerve blocks and nerve ablations to surgical decompression.
  2. Trends Neurosci. 2021 Sep 21. pii: S0166-2236(21)00167-3. [Epub ahead of print]
      The initiation, progression, and metastatic spread of cancer elicits diverse changes in systemic physiology. In this way, cancer represents a novel homeostatic challenge to the host system. Here, we discuss how the hypothalamus, a critical brain region involved in homeostasis senses, integrates and responds to cancer-induced changes in physiology. Through this lens, cancer-associated changes in behavior (e.g., sleep disruption) and physiology (e.g., glucocorticoid dysregulation) can be viewed as the result of an inability to re-establish homeostasis. We provide examples at each level (receptor sensing, integration of systemic signals, and efferent regulatory pathways) of how homeostatic organization becomes disrupted across different cancers. Finally, we lay out predictions of this hypothesis and highlight outstanding questions that aim to guide further work in this area.
    Keywords:  cytokines; feedback loops; hypothalamus; interoception; metabolism; sleep