Pros and Cons of Different Approaches to the Management of Pelvic Cancer Pain

  • B. A. Meyerson
  • S. Arnér
  • B. Linderoth
Conference paper
Part of the Acta Neurochirurgica book series (NEUROCHIRURGICA, volume 33)


Pain due to malignancy in the pelvic region is common and notoriously difficult to relieve. One important reason why this condition often fails to respond both to pharmacological and surgical treatment is that the genesis of the pain may be very complex as the pathological process may involve different types of tissue and organs. Thus, the pain may originate from the viscera, connective tissue, bone, and, of particular significance, from nervous tissue. Pelvic pain often radiates in the hip region or in the leg as a result of injury to the lumbo-sacral plexus, and it is wellknown that neurogenic pain, especially when there is a component of deafferentation, is extremely difficult to alleviate. As will be further discussed in this paper the pain analysis is therefore of utmost importance for the selection of a proper method of treatment. A further characteristic of pelvic cancer pain, which sometimes accounts for therapy failure is that such pain is often poorly localized and has a tendency to be feit in the midline or with bilateral spreading. Some of the destructive procedures available for malignant pain appear to be most suitable for pain confined to one side (cordotomy, neurolytic blocks) and when applied with the aim of producing bilateral effects the risk of serious side-effects and complications is considerably increased.


Cancer Pain Epidural Morphine Pelvic Region Pelvic Cancer Neurogenic Pain 
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Copyright information

© Springer-Verlag 1984

Authors and Affiliations

  • B. A. Meyerson
    • 1
  • S. Arnér
    • 2
  • B. Linderoth
    • 1
  1. 1.Department of NeurosurgeryKarolinska SjukhusetStockholm 60Sweden
  2. 2.Department of AnaesthesiologyKarolinska SjukhusetStockholm 60Sweden

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