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Oncology and Spine Pain

  • Daniel K. Partain
  • Mihir M. KamdarEmail author
Chapter

Abstract

Cancer pain is a significant problem that can severely impact the quality of life of patients and result in increased healthcare utilization. Bone pain is the most common cancer pain syndrome and often arises in the context of spinal metastases. A diagnostic approach to pain arising in the spine can simultaneously rule out potential oncologic emergencies and yield an effective therapeutic plan. The therapeutic approach to managing spine pain in the oncologic population should involve a multimodal, multidisciplinary approach. This chapter will explore a wide array of pharmacologic options, including the role of NSAIDs, corticosteroids, bisphosphonates, RANK-ligand inhibitors, and opioid therapies to manage spine pain. Non-pharmacologic interventions such as radiation, vertebral augmentation, radionuclide therapy, and neuraxial drug delivery will also be discussed. Indications and considerations for spine surgery will also be examined.

Keywords

Spine pain Cancer pain Bone pain Cord compression Compression fracture Opioid Bisphosphonate Corticosteroid RANK-ligand inhibitor Radiation Vertebroplasty Kyphoplasty Epidural Intrathecal Spine surgery 

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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of General Internal MedicineCenter for Palliative Medicine, Mayo ClinicRochesterUSA
  2. 2.Divisions of Pain Medicine and Palliative Care, Massachusetts General HospitalBostonUSA

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