Zusammenfassung
In etwa 60–90 % der Schmerzzustände bei Tumorpatienten sind durch Infiltration, Kompressionen mit konsekutiver Durchblutungsstörung, Ödem, Ulzeration oder Perforation direkt tumorbedingt. 10–25 % der Schmerzzustände sind therapiebedingt. Operation, Chemotherapie, Hormontherapie oder Radiatio können schmerzhafte Folgezustände wie z. B. Neuralgien, Phantomschmerz, Fibrose, Mukositis oder Ödem verursachen. Außerdem unterscheidet man zwischen tumorassoziierten Schmerzursachen wie z. B. Pneumonie, Pilzinfektion, Venenthrombose, Dekubitus (5–20 %) und tumorunabhängigen Schmerzursachen wie z. B. Migräne oder Arthrits (3–10 %). Neben somatischen Ursachen beeinflussen kulturelle, psychosoziale und spirituelle Faktoren das Schmerzerleben. Pathophysiologisch unterteilt man den Karzinomschmerz in den Nozizeptorschmerz und neuropathischen Schmerz bzw. gemischten Schmerz.
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Likar, R., Köstenberger, M., Neuwersch-Sommeregger, S. (2023). Schmerztherapie bei Tumorpatienten. In: Bernatzky, G., Sittl, R., Likar, R. (eds) Schmerzbehandlung in der Palliativmedizin. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-662-64329-7_14
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