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Steinman RH – Clinicians working with patients with chronic cancer–related pain are familiar with the experience of pain having both somatic sensory and psychological components. With adequate pain management, we often see a lessening of anxiety and a return to emotional equilibrium, which allows patients to process the loss inherent in the cancer experience. But in some of our patients we see persistence of psychological suffering and of a maladaptive anxious response that interrupts this processing and worsens outcome. While most anxiety develops after the onset of cancer, a smaller subset of patients with anxiety represent those with preexisting conditions. This issue of Pain: Clinical Updates addresses the complex and bidirectional relationship of chronic pain and anxiety in cancer patients, the dilemmas inherent in adequately diagnosing the underlying cause of this prolonged suffering, and the multimodal treatment approach necessary to improve adaptation and quality of life.


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