European Pain School®

at the University of Siena

European Pain School®

at the University of Siena

EPS 2025 • Cancer Pain

Siena, Italy | 7-13 June 2025

Cancer Pain

Siena, Italy | 7-13 June 2025

Welcome

Background

Certosa

The European Pain School (EPS), founded at the University of Siena (Italy) in 2002, is the first and still the premier school intended for students working on basic science and clinical topics related to acute and chronic pain. EPS has an interdisciplinary perspective and a distinct research orientation. Young scientists at the Ph.D. or postdoctoral levels (or equivalent) in all fields of pain science and pain medicine are encouraged to apply.

Mission and Overview

In the past the basic mechanisms of pain and the neural pathways involved were explored through research on animals and human subjects using well defined noxious stimuli and observing neurophysiological, behavioral and subjective sensory responses. This straightforward approach, however, is not sufficient to understand most of the real-life spontaneous and prolonged pain states that occur in human patients and animals. Rather, chronic pain involves complex and nonlinear functioning of neural and extraneural systems resulting in the maintenance of the pain process.

Long known are inflammatory mechanisms that can induce a prolonged pain state mediated by pain-producing substances of multiple origin including the immune system, with cytokines stimulating peripheral nociceptors or neurons of the central somatosensory system. Prolonged and enhanced activation of the central pain system may also be due to failure of inhibitory controls in the CNS, a likely mechanism in neuropathic pain. Control by both GABA and endogenous opioids may be affected, causing persistent pain and allodynia. Altered control may also be mediated by cytokines released from activated astrocytes and microglia in the CNS.

The mammalian pain system shows a clear sexual dimorphism that may depend on hormonal influences during peri- and postnatal nervous system development, among other causes. This sexual dichotomy has consequences for pain expression and for psychosocial and medical consequences of pain in males and females, including e.g. the process of pain chronification. Recognition of this dichotomy is resulting in developments in pain medicine that take gender into account.

The European Pain School believes in the advancement of interdisciplinary programs for the ultimate benefit of pain patients, disseminating this vision especially among junior investigators interested in basic and clinical research on pain.

2025 Edition: Cancer Pain

The complex relationship between cancer and pain will be the topic of the 2025 EPS edition. Pain affects a significant percentage of cancer patients, with approximately 20% to 50% experiencing its effects. Moreover, about 80% of those with advanced-stage cancer report moderate to severe pain, originating from the primary tumor itself or its metastases. However, treatments such as surgery, radiation therapy, chemotherapy, targeted therapy, and supportive care can also induce pain. Despite advancements in targeted cancer treatments, radiotherapy, and chemotherapy, which remain fundamental in oncology, are often associated with polyneuropathies and localized or diffuse pain. Both acute and chronic cancer pain, characterized by nociceptive or neuropathic features, involve a multitude of mediators derived from cancer cells or the tumor microenvironment, which interact with surrounding nerve fibers. The tumor microenvironment releases various algogenic mediators, including protons, bradykinin, endothelins, prostaglandins, growth factors, cytokines, proteases and other factors which activate and/or sensitize nociceptors. Increasing evidence suggests the involvement of immune and inflammatory cells in the development and maintenance of cancer pain. Additionally, the peripheral nervous system plays a significant role in modulating tumor initiation and progression, contributing to pain through mechanisms such as transformation, invasion, metastasis, and the development of chemoresistance. Perineural invasion has emerged as a novel area of investigation, shedding light on the dissemination of cancer and the associated pain. Furthermore, peripheral glial cells have been identified as crucial mediators in encoding chronic pain across various pain conditions, including cancer-related pain. Lectures at the EPS edition will delve into these areas, highlighting recent advancements and technologies aimed at identifying novel targets for managing breakthrough and chronic cancer pain.

Topics

  • Nociceptor excitation/sensitization by the cancer microenvironment
  • Cancer pain, cytokines and growth factors
  • Role of the immune system in cancer pain
  • Central and peripheral glial cells in cancer pain
  • Antioxidant mechanisms and neuropathic cancer pain therapy
  • The role of proteases in cancer pain
  • Rodent models of chemotherapy-induced peripheral neurotoxicity
  • Opioid-induced neurotoxicity in cancer pain
  • Neurobiological mechanisms of placebo and nocebo effects
  • Psychological features of cancer pain patients

Faculty 2025

Anna Maria Aloisi, Siena, Italy
Ofrit Bar-Bachar, Ramat Yishai, Israel
Carlo V. Bellieni, Siena, Italy
Giancarlo Carli, Siena, Italy
Luana Colloca, Baltimore, MD, USA
Lesley Colvin, Dundee, United Kingdom
Francesco De Logu, Florence, Italy
Pierangelo Geppetti, Florence, Italy
Marzia Malcangio, London, United Kingdom
Sebastiano Mercadante, Palermo, Italy
Daniela Salvemini, St. Louis, MO, USA
Peter Reeh, Erlangen, Germany
Brian L. Schmidt, New York, NY, USA
Camilla Svensson, Stockholm, Sweden
Irina Vetter, Brisbane, Australia

Past cycles of the School

EPS 2024Pain and the Immune System (9-15 June 2024)

EPS 2023Neuro-immune Interactions in Nociception, Pain and Itch (10-17 June 2023)

EPS 2022Pain, Inflammation and the Guts (11-18 June 2022)

EPS 2021Pain, Inflammation and the Guts (Online, 14-19 June 2021)

EPS 2020Pain, Inflammation and the Guts (rescheduled)

EPS 2019Headaches and Facial Pain (9-16 June 2019)

EPS 2018Pain: from Fetus to Old Age (10-17 June 2018)

EPS 2017CNS vs PNS Contributions to Persistent Pain (4-11 June 2017)

EPS 2016Pain: Neurons, Gender and Society (5-12 June 2016)

EPS 2015Plasticity in neural processing as a mechanism in chronic pain (7-14 June 2015)

EPS 2014Spontaneous versus Evoked Pain in Animals and Humans (8-15 June 2014)

EPS 2013Brain Modulation of Pain Experience (9-16 June 2013)

EPS 2012Evolution of Concepts on Pain (3-10 June 2012)

EPS 2011Pain: Bridging Molecules and Mind (12-19 June 2011)

EPS 2010Translating Pain Science into Pain Medicine (30 May - 6 June 2010)

EPS 2009Molecular Mechanisms of Pain Response (13-20 June 2009)

EPS 2008Hyperexcitable Neurons as Pain Generators (15-22 June 2008)

EPS 2007Pain Syndromes: Science and Medical Practice (17-24 June 2007)

EPS 2006Pain and the Central Nervous System (12-17 June 2005)

EPS 2005Chronic Pain a Disease: The Role of Genes (6-11 June 2005)

EPS 2003Chronic Pain a Disease: Novel Scientific Concepts (25-31 October 2003)

 

School Executive Board

School Director
Anna Maria Aloisi
Siena, Italy

Scientific Programme Directors
Giancarlo Carli
Siena, Italy
Pierangelo Geppetti
Florence, Italy

Further Members
Marzia Malcangio
London, United Kingdom
Peter Reeh
Erlangen, Germany
Camilla Svensson
Stockholm, Sweden

Important dates

Application deadline:
EXTENDED TO
28 February 2025

Notification of selections:
24 February 2025

Deadline for attendance confirmation:
3 March 2025

With the support of

IASP

Medoc

UgoBasile

Biomedicina e nutrizione

Poster

Call for applications
Feel free to download it and distribute in your Institution.

Poster

Call for applications
Feel free to download it and distribute in your Institution.