A 65-Year-Old Man with Poor Cancer Pain Control Despite Intrathecal Pump

Abstract

Cancer is a public healthcare problem and is the second leading cause of death in the United States. Cancer pain occurs in varying degrees depending on the disease stage, type of cancer, and location where 75% of cancer patients will complain of pain at some stage of their disease (Bao et al., Cochrane Database Syst Rev 10:CD011108, 2016). Intrathecal pump (ITP) was first reported as an effective cancer pain treatment modality in 1981 (Onofrio et al., Mayo Clin Proc 56(8):516–520, 1981; Wang et al., Anesthesiology 50(2):149–151, 1979). Advances in technology over the past 30 years have rendered ITP as an effective modality for treating intractable cancer pain; however, this modality requires sufficient knowledge and expertise for implantation and management. We will discuss some of the important aspects of ITP therapy in cancer pain patients, factors to consider in case of poor pain control in previously stable patients with ITP therapy thus avoiding long-term serious complications.