Abstract text (incl. figure legends and references)

Patients with oropharyngeal, head and neck cancer often experience pain and suffering that reduces quality of life, increases anxiety and depression, affects well being and even compliance with treatment. Also, oral manifestations of hematologic cancers and metastasis to oral tissues may cause pain with similar effects. Orofacial pain can be due to cancer itself, due to cancer therapy or due to noncancerous etiology in cancer patients. Even cancer therapy is well known to frequently induce painful oral complications.

Pathogenesis of oral cancer is not fully understood and various mediators like endothelin-1, proteases and nerve growth factor have been implicated. Effective management of orofacial pain in patients with cancer requires comprehensive assessment of multifactorial etiologies and treatment directed at these causative factors.

Orofacial pain in cancer patients remains a prevalent and debilitating condition with significant social and economic impacts. Clearly the task required is integration of knowledge in this anatomically dense region, traditionally divided between many medical disciplines. Management of orofacial pain requires a professional collaboration between dentists and medical doctors. Dentists, Orofacial pain specialists in particular, play an important role in screening oropharyngeal, head and neck cancer patients, helping in the diagnosis and management by making appropriate referrals. Based on extensive clinical experience with patients suffering from facial pain and headache, an Orofacial pain clinician, being part of the multidisciplinary team, is well equipped to fulfill the task of giving adequate relief to orofacial pain in cancer patients and thereby improving quality of life.

Orofacial pain in patients with cancer can be managed by using topical therapy, non-opioid and strong opioid analgesics, adjuvant and centrally acting analgesics as well as adjunctive or complementary management strategies.