Services for Cancer-Related Pain
Pain is one of the most common symptoms of cancer. Nearly 30-50% of cancer patients undergoing cancer treatment and nearly 80-90% of patients with advanced disease suffer from moderate to severe pain.
Along with various pharmacological therapies, we offer image-guided advanced interventional pain management techniques as an adjunct to medical management or as primary therapy for cancer pain. One of the most successful interventional pain management techniques we offer is spinal drug delivery for refractory pain related to advanced cancer. The spinal drug delivery technique is often an ideal choice for many advanced cancer patients as it provides improved pain control with fewer side effects and thus improved quality of life. The Mass General Cancer Center is one of the largest oncology practices in the country. We provide our expertise to our Oncology colleagues to help manage their patients' refractory cancer pain. We are committed to accommodating new consults for cancer patients with pain on the same day of the referral. In collaboration with the Mass General Palliative Care team, we have an additional "Advanced Cancer Pain Clinic" each Wednesday afternoon at the Yawkey Cancer Center. The focus of this clinic is to offer multidisciplinary, patient-focused care with advanced pain management techniques for patients with complex needs.
Spinal drug delivery (SDD) is being used with success for intractable pain conditions. The non-destructive nature and reversibility of SDD makes this method an attractive alternative to neuroablative procedures (procedures where nerves are irreversibly ablated) for refractory pain. The continual improvement of spinal drug delivery pump technology, the addition of newer medications, and the success of combining opioids with adjuvants contribute to the rise of this mode of therapy. Recent findings from a randomized controlled study on SDD vs. comprehensive medical management for refractory cancer pain indicates that there is better pain control, fewer side effects and potentially greater survival among cancer patients with SDD therapy. At the Mass General Center for Pain Medicine, we have provided this advanced interventional therapy for refractory pain for over a decade.
We work closely with our referring physicians (oncologists, palliative care physicians and PCPs) to select appropriate candidates for SDD therapy. The process begins with an initial consultation (outpatient or inpatient). If deemed appropriate, patients undergo a trial with the placement of a temporary percutaneous catheter for several days. If the patient achieves more than 50% pain relief and improvement of side effects over the trial period, as compared to their previous therapies, the trial is considered successful. During the trial period, the patient, family and referring team participate in the decision whether to continue the therapy. An indwelling device is surgically placed for long-term SDD therapy. The patient is followed during the therapy and receives periodic refills for his or her pump.