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Old 04-20-2009, 08:07 AM
No Wikipedia Cites No Wikipedia Cites is offline
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Why does cancer cause such pain if it's just cells multiplying?

In description of people's terminal cancer, they are always suffering from great pain, usually requiring heavy drugs such as morphine.

Technically speaking, I would ask why exactly does the cancer 'hurt'? I can understand falling down stairs and being hurt, but why does the cancer actually cause pain? And why only at the end -- and not when it first begins?
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  #2  
Old 04-20-2009, 08:16 AM
Bijou Drains Bijou Drains is offline
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I think mainly because it crowds out normal cells with abnormal cells. The tumors press on bones, nerves and organs.
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Old 04-20-2009, 08:29 AM
bordelond bordelond is offline
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And then ... sometimes, the patient "lucks out" and the cancer cells cause no pain at all for quite some time. Years pass. Then the patient goes to the doctor for some vague stomach pain, and out comes a tumor the size of a softball.

IIUC, it's also possible to die suddenly from cancer without ever having felt pain at all.
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Old 04-20-2009, 08:45 AM
Smeghead Smeghead is offline
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If you're thinking of modern times, chemotherapy is also quite painful on its own.
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Old 04-20-2009, 08:57 AM
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Inflammation is painful, and sometime brutally so. Depending on where the cancer is and what type, etc, there will be certain amounts of inflammation in the area.

If you ever saw someone with crippling back pain, just imagine: a wee bit of inflammation in the tiniest little area (little spot on a nerve) can take down a 200 pound man in awesome physical shape...and get him so bad he might be addicted to narcotics at some point.
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Old 04-20-2009, 11:01 AM
Bijou Drains Bijou Drains is offline
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Chemo works on all fast growing cells, not just cancer which is why your hair falls out and it can mess up your stomach cells too which is why people often throw up.
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  #7  
Old 04-20-2009, 01:43 PM
smiling bandit smiling bandit is offline
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Yes, cancer can cause a lot of pain, no pain, or some pain depending on the type of cancer and where it is located. If it doesn't pop up in an area with a lot of nerves, it may not be noticable at all. Even in seemingly-sensitive tissue like the breasts and testicles, it can grow without notice.
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Old 04-20-2009, 05:11 PM
Fear Itself Fear Itself is online now
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I had no pain at all when I was diagnosed with testicular cancer. Found a pea-sized tumor by accident.
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Old 04-20-2009, 08:35 PM
KarlGauss KarlGauss is online now
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Quote:
Originally Posted by sassyfras View Post
In description of people's terminal cancer, they are always suffering from great pain, usually requiring heavy drugs such as morphine.
As others have noted, cancer does NOT always cause pain. In fact, IIRC, only a minority of cancer patients, "only" 30 to 35 percent or so, have significant pain (although the figure is much higher if the patient has advanced disease).

The mechanism of pain arising in cancer patients is multifactorial. As a rule, though, the original collection or mass of cancer cells (i.e. where everything started) tends not to cause pain. Pain occurs when other structures are invaded (this is usually due to either direct invasion or by cancer cells traveling through the blood and/or lymph to a distant site and "planting roots there". This latter process is called metastatic spread. Individual sites of spread are called metastases.,or "mets" for short)

Typically, it is the surface of organs which are pain sensitive. More specifically, there is a "capsule" surrounding the internal organs, and it is this capsule that's pain sensitive. Until and unless the surface of a distant organ has been involved by cancer, there's probably not going to be a lot of pain there. Another possibility for pain production in cancer occurs when the organ is so full of cancer cells that it distends and stretches the capsule wrapped around it. Finally, or penultimately actually, as has been noted, when cancers invade into nerves or simply press on them, pain will result. That type of cancer pain can be very difficult to treat with conventional therapy.

There is one 'organ' which merits special attention when discussing cancer and pain. Specifically, invasion into or metastatic spread into BONE can be very painful. Unfortunately, bone is a common site for cancers to spread to (metastasize). Cancers of the lung, breast, prostate, and antibody-producing cells (i.e. multiple myeloma) often spread to bone. Interestingly, cancers of the bowel, stomach, pancreas, ovary, and a number of others go to bone much less commonly. For 5 points, please explain why.
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Old 04-20-2009, 08:52 PM
Bijou Drains Bijou Drains is offline
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Some tumors spread to bone because they need calcium? Also tumors tend to spread to areas that have similar type tissue or where the tissue arises from a similar type of stem cell.

I had a coworker die of lung cancer that spread to his brain. He died only about 3 months after it was found. At first he thought the head pain was from some dental problems he was having so he did not get it checked right away. I thought he had a brain tumor but I did not know until after he died that it was actually lung cancer. Most brain tumors are tumors that spread from somewhere else.
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  #11  
Old 04-20-2009, 09:56 PM
Chief Pedant Chief Pedant is offline
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Quote:
Originally Posted by KarlGauss View Post
Cancers of the lung, breast, prostate, and antibody-producing cells (i.e. multiple myeloma) often spread to bone. Interestingly, cancers of the bowel, stomach, pancreas, ovary, and a number of others go to bone much less commonly. For 5 points, please explain why.
Because PT Barnum Loves Kids. Thyroid and Kidney should be on your bone met list.

Sorry; it's late and I'm tired.

How do I redeem the 5 points?

http://www.ncbi.nlm.nih.gov/pubmed/12154351 for a non-medical student answer.

Oh yeah...back to the OP. The complications of cancer such as broken bones, pinched nerves from broken bones, and bowel obstruction can be extraordinarily painful, in addition to the other points made by KarlGauss.

Last edited by Chief Pedant; 04-20-2009 at 09:58 PM..
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  #12  
Old 04-21-2009, 10:11 AM
KarlGauss KarlGauss is online now
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Quote:
Originally Posted by Chief Pedant View Post
Because PT Barnum Loves Kids. Thyroid and Kidney should be on your bone met list.
Absolutely, but I didn't want to overload with information. For that matter, we could refer to the "bone-zene ring" and thus add adrenal Ca as well:

Code:
                               thyroid
                        /                       \
             lung                                breast
               |                                    |
             renal                               adrenal
                       \                         /
                              prostate
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  #13  
Old 04-21-2009, 10:56 AM
bordelond bordelond is offline
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Quote:
Originally Posted by KarlGauss View Post
Absolutely, but I didn't want to overload with information. For that matter, we could refer to the "bone-zene ring" and thus add adrenal Ca as well:

Code:
                               thyroid
                        /                       \
             lung                                breast
               |                                    |
             renal                               adrenal
                       \                         /
                              prostate
Is this because of proximity to bone (e.g. thyroid close to neck vertebrae, lung/breast to ribs, kidney/adrenals to lower ribs or spine, prostate to lower pelvis)? The other cancers you were mentioning seemed to be in the viscera, and perhaps sufficiently "insulated" from bone.
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  #14  
Old 04-21-2009, 11:36 AM
ivylass ivylass is offline
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Quote:
Originally Posted by Bijou Drains View Post
Chemo works on all fast growing cells, not just cancer which is why your hair falls out and it can mess up your stomach cells too which is why people often throw up.
Not anymore. They give you anti-nausea meds to treat the symptoms. The worst I had was some queasiness. The Neulasta shot (white blood cell booster) was the one that made me feel like I'd been hit by a car.
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  #15  
Old 04-21-2009, 05:31 PM
Chief Pedant Chief Pedant is offline
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Quote:
Originally Posted by bordelond View Post
Is this because of proximity to bone (e.g. thyroid close to neck vertebrae, lung/breast to ribs, kidney/adrenals to lower ribs or spine, prostate to lower pelvis)? The other cancers you were mentioning seemed to be in the viscera, and perhaps sufficiently "insulated" from bone.
No.

Bony metastases are often distal, and diffuse. These cancers do not necessarily spread to adjacent bone. The spread to bone is hematogenous (blood borne). KarlGauss is pointing out their affinity to park in bone and form new little junior cancers (metastases) there.
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