Open AccessThe American Society of Pain and Neuroscience (ASPN) Best Practices and Guidelines for the Interventional Management of Cancer-Associated Pain
Author(s) -
Mansoor M. Aman,
Ammar Mahmoud,
Timothy R Deer,
Dawood Sayed,
Jonathan M Hagedorn,
Shane E. Brogan,
Vivek K. Singh,
Amitabh Gulati,
Natalie Strand,
Jacqueline Weisbein,
Johnathan Goree,
Fangfang Xing,
Ali Valimahomed,
Daniel Pak,
Antonios El Helou,
Priyanka Ghosh,
Krishna B. Shah,
Vishal Patel,
Alexander Escobar,
Keith T. Schmidt,
Jay M. Shah,
Vishal Varshney,
William S. Rosenberg,
Subirang
Publication year - 2021
Publication title -
journal of pain research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 49
ISSN - 1178-7090
DOI - 10.2147/jpr.s315585
Subject(s) - medicine , cancer pain , interventional pain management , neuromodulation , palliative care , pain medicine , cordotomy , intensive care medicine , interventional radiology , malignancy , cancer , chronic pain , physical therapy , surgery , anesthesia , anesthesiology , spinal cord , nursing , psychiatry , stimulation
Moderate to severe pain occurs in many cancer patients during their clinical course and may stem from the primary pathology, metastasis, or as treatment side effects. Uncontrolled pain using conservative medical therapy can often lead to patient distress, loss of productivity, shorter life expectancy, longer hospital stays, and increase in healthcare utilization. Various publications shed light on strategies for conservative medical management for cancer pain and a few international publications have reviewed limited interventional data. Our multi-institutional working group was assembled to review and highlight the body of evidence that exists for opioid utilization for cancer pain, adjunct medication such as ketamine and methadone and interventional therapies. We discuss neurolysis via injections, neuromodulation including targeted drug delivery and spinal cord stimulation, vertebral tumor ablation and augmentation, radiotherapy and surgical techniques. In the United States, there is a significant variance in the interventional treatment of cancer pain based on fellowship training. As a first of its kind, this best practices and interventional guideline will offer evidenced-based recommendations for reducing pain and suffering associated with malignancy.