Interventional pain techniques can provide patients with cancer additional options to help manage their pain, according to recent data published in the journal Annals of Palliative Medicine. The modalities can also help reduce opioid consumption and negative side effects associated with their use.1
Pain is one of the most common symptoms in patients with cancer, with research finding nearly 44.5% of patients with cancer reporting pain. If not relieved sufficiently, it can have a significant impact on the quality of life of patients with cancer and can even lead to increased symptoms of depression, anxiety, and anger. However, pain in patients with cancer is undertreated, with a 40.2% prevalence of undertreatment in 2022.2
Key Takeaways
- A scoping review of interventional pain management techniques for cancer patients revealed that these modalities carry minimal risk while providing effective pain relief.
- These techniques, ranging from nerve blocks to implantable devices, can reduce opioid consumption and mitigate concerns related to opioid misuse and side effects.
- With advancements in technical expertise and imaging technologies, interventional pain techniques are becoming increasingly viable as frontline options for managing cancer-related pain.
“[Pain] undertreatment has been linked to concerns about medication side effects, opioid misuse, difficulty in getting pain medications due to increasing regulatory requirements and hurdles in insurance coverage for opioid pain medications,” the authors wrote. “This has led to a growing focus on various interventional pain therapies that can reduce pain medication requirements, and their associated side effects.”
READ MORE: Complementary Health Approaches for Pain Management Increasing in Popularity
A team of investigators conducted a study to review interventional pain and minimally invasive neurosurgical options for pain management in patients with cancer. Data was collected from PubMed, Cochrane, and Embase databases. The scoping review included 137 articles, case series, and randomized controlled trials.
Interventional pain techniques require certain general indications before they are performed, these include that refractory and intractable pain has not responded to traditional medical management, a history of opioid use disorder, that a trial of analgesic has been performed, and that a detailed history and examination on the etiology of the pain has been conducted. If a patient has met these and other indications, some of the interventions for pain management include, neuromodulation, kyphoplasty, spinal cord stimulation, and minimally invasive neurosurgical interventions.
“These procedures range from simple muscle and nerve blocks to more complex implantable treatment modalities and CNS ablations,” the authors wrote. “[K]nowing about these procedures can provide additional potent options for oncology and palliative care clinicians in their cancer pain management armamentarium.”
Investigators found that the interventional pain modalities that are currently available carry little risk and can provide patients with cancer effective pain relief. They can also help reduce concerns related to opioid abuse and opioid use disorder. Each of the techniques allow for pain relief in various stages of cancer—including survivorship—and more focused techniques can help at different points on the body.
Additionally, with increasing technical and clinical expertise, and enhanced imaging technologies, these interventional pain techniques can offer a more effective method of pain management than previously used methods. The authors added that interventional pain options should be considered a frontline option, in addition to conservative use of medications like opioids.
“Refractory cancer pain significantly reduces the quality of life in advanced cancer patients,” the authors concluded. “Interventional pain procedures provide an extra option for pain management for cancer patients beyond traditional medical management for intractable refractory pain. In addition to refractory pain management, they can be very useful if side effects from medications preclude optimal pain management. Furthermore, with growing concerns regarding opioid epidemic, and addiction related issues, they provide an extra option for pain management.”
READ MORE: Pain Management Resource Center
References
1. Habib MH, Schlögl M, Raza S, Chwistek M, Gulati A. Interventional pain management in cancer patients-a scoping review. Ann Palliat Med. 2023;12(6):1198-1214. doi:10.21037/apm-23-433
2. Snijders RAH, Brom L, Theunissen M, van den Beuken-van Everdingen MHJ. Update on Prevalence of Pain in Patients with Cancer 2022: A Systematic Literature Review and Meta-Analysis. Cancers (Basel). 2023;15(3):591. Published 2023 Jan 18. doi:10.3390/cancers15030591
