In this week's episode of the Spine & Nerve podcast Dr. Nicolas Karvelas and Dr. Brian Joves present a clinical case of a patient with advanced metastatic prostate cancer who presented with severe refractory cancer associated pain.  The patient’s cancer associated pain is due to multiple factors including bone pain secondary to metastases to bone, as well as neuropathic pain in setting of chemotherapy induced peripheral neuropathy.  These cases can be very challenging in regard to the development of a treatment regimen that is adequately controlling the patient’s symptoms without significant side effects.  

 

Cancer associated pain is common with epidemiologic studies finding that around 70-90% of patients with advanced cancer reporting significant pain that impacts their daily function and quality of life.  The World Health Organization analgesic ladder and the European Association for Palliative Care Guidelines have provided guidance for management of this pain that is helpful and important to reference.  

It is also important to be aware of the multitude of the treatment options available for these difficult cases.  Listen as the doctors discuss some of the treatment options available for advanced cancer associated pain including the utilization of corticosteroids (including the potential adverse effects to be vigilant for), as well as utilization of neuromodulation options.  

 

 

References:

1. The Role of Corticosteroids in the Treatment of Pain in Cancer Patients. Curr Pain Headache Rep. 2012.

2. Yakovlev AE, Resch BE. Spinal cord stimulation for cancer‐related low back pain. American Journal of Hospice and Palliative Medicine 2011;29(2):93‐7.

This podcast is for information and educational purposes only, it is not meant to be medical or career advice. If anything discussed may pertain to you, please seek council with your healthcare provider. The views expressed are those of the individuals expressing them, the may not represent the views of Spine & Nerve.