The American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain

• Type of Material: Article
• Authors: Vinita Singh, Emory University; Mansoor M Aman, Advocate Aurora Health; Ammar Mahmoud, Northern Light Health Eastern Maine Medical Center; Timothy Deer, The Spine and Nerve Center of the Virginias; Dawood Sayed, University of Kansas; Jonathan M Hagedorn, Mayo Clinic, Rochester; Shane E Brogan, University of Utah; Amitabh Gulati, Memorial Sloan Kettering Cancer Center; Natalie Strand, Mayo Clinic, Phoenix; Jacqueline Weisbein, University of Arkansas Medical Sciences; Johnathan H Goree, Napa Valley Orthopedic Medical Group; Fangfang Xing, Swedish Health Services; Ali Valimahomed, Gramercy Pain Center; Daniel J Pak, New York-Presbyterian Hospital; Antonios El Helou, Moncton Hosp; Priyanka Ghosh, Remedy Medical Group; Krishna Shah, Baylor College of Medicine; Vishal Patel, Advocate Aurora Health; Alexander Escobar, University of Toledo; Keith Schmidt, St. Alexius Medical Center; Jay Shah, SamWell Inst Pain Management; Vishal Varshney, Providence Healthcare; William Rosenberg, Midwest Neurosurg Associates; Sanjeet Narang, Harvard Medical School
• Language: English
• Date: 2021-01-01
• Publisher: DOVE MEDICAL PRESS LTD
• Publication Version: Final Published Version
• Copyright Statement: © 2021 Aman et al.
• License: Creative Commons Attribution-Noncommercial 3.0 Unported
• Final Published Version (URL): http://dx.doi.org/10.2147/JPR.S315585
• Title of Journal or Parent Work: JOURNAL OF PAIN RESEARCH
• Volume: 14
• Start Page: 2139
• End Page: 2164
• Keywords: RADIOFREQUENCY ABLATION; INTRACTABLE PAIN; radiofrequency; GUIDED PERCUTANEOUS CORDOTOMY; UNRESECTABLE PANCREATIC-CANCER; intrathecal drug delivery; CELIAC PLEXUS NEUROLYSIS; Life Sciences & Biomedicine; Neurosciences & Neurology; QUALITY-OF-LIFE; Clinical Neurology; DRUG-DELIVERY SYSTEMS; cancer pain; SPINAL-CORD STIMULATION; vertebral augmentation; neuromodulation; CONFERENCE PACC RECOMMENDATIONS; DOUBLE-BLIND; spinal cord stimulation; neurolysis; Science & Technology; ketamine; pain pump
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

Moderate to severe pain occurs in many cancer patients during their clinical course and may stem from the primary pathology, metastasis, or as treatment side effects. Uncontrolled pain using conservative medical therapy can often lead to patient distress, loss of productivity, shorter life expectancy, longer hospital stays, and increase in healthcare utilization. Various publications shed light on strategies for conservative medical management for cancer pain and a few international publications have reviewed limited interventional data. Our multi-institutional working group was assembled to review and highlight the body of evidence that exists for opioid utilization for cancer pain, adjunct medication such as ketamine and methadone and interventional therapies. We discuss neurolysis via injections, neuromodulation including targeted drug delivery and spinal cord stimulation, vertebral tumor ablation and augmentation, radiotherapy and surgical techniques. In the United States, there is a significant variance in the interventional treatment of cancer pain based on fellowship training. As a first of its kind, this best practices and interventional guideline will offer evidenced-based recommendations for reducing pain and suffering associated with malignancy.