Publication date: Jul 12, 2019
There is a growing recognition of the role of interventional techniques (IT) for the management of cancer pain (CP). However, there are many controversies on how and when to use such techniques. Areas covered: Patients who are unresponsive to systemic opioid analgesics or patients unable to tolerate systemic opioids may benefit from different IT for which the successful use depends on the selection of the right therapy for the right patient. The evidence regarding these techniques is often anecdotal and the potential risks, benefits, alternatives, and complications should be balanced to take a decision. Expert opinion: The successful use of IT depends on many factors, including a careful assessment of previous treatments, patient’s characteristics, and the logistics. Risks, benefits, alternatives, and complications should be balanced to take a decision. Although IT have been described as effective in patients with CP, the evidence is still limited, unless for celiac plexus block, which has a high benefit-risk ratio. The intrathecal therapy should be chosen in patients who were poorly responding to opioid therapy, after an appropriate trial with different opioids. A careful selection of patients and techniques, a large experience in performing the procedures, sufficient logistics and staff skills, appropriate indications, and assessment of benefits and risks may help to achieve the best benefit for patients in individual cases.
Mercadante, S. and Candido, K.D. The use of alternative therapies in conjunction with opioids for cancer pain. 03748. 2019 Expert Rev Anticancer Ther.
- Interventional Pain Treatments in the Management of Oncologic Patients with Thoracic Spinal Tumor-Related Pain: A Case Series.
- FDA Issues Guidance to Assess Benefit-Risk of Opioids Prior to Approval
- Kalytera Announces Additional Progress with Cannabinoid-Based Compound for Treatment of Acute and Chronic Pain
- Attempts to Limit Opioid Prescribing in Critically Ill Patients: Not So Easy, Not So Fast.