Dr. Rosenberg, in collaboration with colleagues at University of Michigan and University of Texas MD Anderson Cancer Center, has published an article in Pain Medicine reporting a series of cancer patients whose pain was successfully treated by both intrathecal drug delivery (a “pain pump”) as well as modification of the pain processing system in the central nervous system through cordotomy or myelotomy. This study is important in illustrating the potential for overall pain control and improvement in quality of life by using a “toolbox” approach, in which all different clinical “tools” are considered and used. This can be far superior to the limited list of possibilities that is usually considered in treating cancer-related pain, both in terms of pain control and limiting the effects of pain medications (tiredness, nausea and vomiting, loss of appetite, etc.)
It is important for every cancer patient to realize that pain is not a necessary consequence of having cancer. The health care provider who is caring for the patient should continuous consider new options for pain control, sometimes revisiting options that had been previously ruled out. In addition, cancer patients who are in pain should expect their health care provider to work toward effective pain control WITHOUT unacceptable side effects. While this is not always achievable, it often is – if a “big toolbox” is used.