Malignant Pain

  • Kenneth D. Candido
  • Teresa M. Kusper
Chapter

Abstract

Pain is a ubiquitous complication of the antineoplastic therapy in many cancer patients and survivors. A satisfactory pain management might possibly be the most challenging aspect of symptom control in this patient population. With the development of more elaborate and efficacious oncologic therapies, it is reasonable to expect a rise in the prevalence of malignant pain syndromes. Suboptimal pain relief has several important implications on patients’ health, well-being, and quality of life. Poor pain control can lead to physical decline, sleep disturbance, maladaptive coping skills, difficulty or lack of motivation to participate in therapy, increased financial expenditure, anhedonia or depressive illness, withdrawal or isolation, and suicidality. Interventional techniques are a critical part of the multimodal approach to malignant pain management. They are a powerful tool in abolishing difficult to treat or refractory cancer-related pain states. The focus of this chapter is a concise overview of major pain management interventions available to control the cancer-related pain: peripheral nerve blocks, neurolytic procedures, neuromodulation, intrathecal drug devices, and vertebral augmentation. While the chapter is not all inclusive, it highlights key points related to selected interventions and provides data supporting the use of individual modalities in the treatment of cancer-related pain. Decreased opioid requirements and reduced risk of medication-related adverse reactions are most notable benefits of the interventional pain management, which are confirmed by a growing number of available evidence.

Keywords

Malignant pain Cancer-related pain Breakthrough pain Opioids Chemotherapy-induced pain Interventional pain techniques Regional anesthesia Peripheral nerve blocks Neurolytic blocks Intrathecal pump Neuromodulation Spinal cord stimulator Vertebral augmentation Vertebroplasty Kyphoplasty 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Kenneth D. Candido
    • 1
    • 2
  • Teresa M. Kusper
    • 1
  1. 1.Department of AnesthesiologyAdvocate Illinois Masonic Medical CenterChicagoUSA
  2. 2.Departments of Surgery and AnesthesiologyUniversity of Illinois College of MedicineChicagoUSA

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