Unfortunately, pain comes in many sizes and shapes for the patient with cancer. Not only is pain caused by tissue destruction or transformation produced by the cancer itself, but it also may be a long lasting or even late effect of cancer treatment. Cancer can destroy bone and other tissue, can distort viscera, and can impinge on neural structures, all with the potential for causing pain. Cancer therapies can also result in painful neuropathy, produced by toxic or traumatic damage to peripheral and central neural structures. The two sections of this chapter report on the status of research in two common types of pain that patients with cancer may experience.

In the first section, Juan Miguel Jimenez-Andrade and Patrick Mantyh address the issue of disease-related pain, focusing primarily on pain that is the result of changes in bone produced by the cancer itself. In the second section, Haijun Zhang and Patrick Dougherty focus on pain produced as a side effect of neural destruction. Whereas pain from either source can be extremely disabling, the mechanisms causing these two types of pain are distinct, and call for differences in approaches to treatment as well as in research for developing new target agents for pain management.