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Review
. 2025 Sep 15;131(18):e70080.
doi: 10.1002/cncr.70080.

The 3P-CP model: Expanding our conceptualization of cancer pain

Desiree R Azizoddin  1   2 , Jian Zhao  1   2 , Tamara J Somers  3   4 , Sarah E Taylor  5 , Joseph G Winger  6 , Susan G Dorsey  7 , Sarah Orris  8 , Anaanya Nasta  8 , Yael Schenker  9   10 , Jessica S Merlin  8 , Heather S L Jim  11 , Kristin L Schreiber  12 , Hailey W Bulls  8   9   10
Affiliations
Review

The 3P-CP model: Expanding our conceptualization of cancer pain

Desiree R Azizoddin et al. Cancer. .

Abstract

Cancer pain is a complex, multifactorial, and growing public health challenge affecting millions of Americans. Effective pain management is essential for comprehensive cancer care, influencing physical and mental health, quality of life, and functional ability. However, progress in cancer pain management is hindered by the complexity of the issue and a fragmented understanding of the myriad factors shaping the pain experience. Additionally, traditional pain terminology-"acute" (<6 months) and "chronic" pain (≥6 months)-offers limited utility in cancer contexts, highlighting the need for a more nuanced framework. To address this gap, we propose the 3P-CP model, which conceptualizes cancer pain through three interconnected phases: predisposing factors that increase cancer pain risk, precipitating factors that trigger cancer pain onset, and perpetuating factors that sustain or exacerbate cancer pain over time. This model provides a structured approach to assess the dynamic nature of cancer pain across the entirety of the cancer trajectory. In this paper, key factors associated with each phase of the 3P-CP model are outlined and their implications for research and clinical care explored. Aligning with the oncology field's shift toward precision medicine, the 3P-CP model has the potential to guide comprehensive assessment, risk mitigation, prevention, and intervention strategies-supporting efforts to deliver the right targeted and tailored treatments, to the right patients, at the right time.

Keywords: cancer pain; conceptual framework; pain management; precision medicine; survivorship.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

FIGURE 1
FIGURE 1
3P‐CP model, illustrating one cycle of cancer pain development and maintenance. 3P‐CP indicates the 3P framework to cancer pain.
FIGURE 2
FIGURE 2
3P definitions, examples, and future directions.
FIGURE 3
FIGURE 3
Example case conceptualizations.
See this image and copyright information in PMC

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