Spinal cord stimulation in the management of neuropathic pain in cancer patients: case report

Abstract

Introduction: Neuropathic pain is present in up to 40 % of all cancer patients. A considerable number of patients fail to achieve enough pain relief with conventional treatment, which is why therapeutic alternatives such as spinal cord stimulation should be considered.
 Case description and results: This is the case of a female patient with chronic neuropathic pain secondary to a partial femoral nerve injury sustained during resection and lymph node dissection surgery with curative intent for a large stage II cell squamous cell carcinoma T2N0M0, localized in the right popliteal fossa. The patient presented with difficult to manage chronic neuropathic pain, despite receiving multiple oral analgesics and nerve blocks. A medullary neurostimulator was implanted that relieved the patient’s pain intensity in up to 80%, in addition to improved function and quality of life.
 Conclusions: spinal cord stimulation is considered an effective neuromodulatory intervention which has shown satisfactory results in the treatment of various types of refractory chronic pain in cancer patients, including neuropathic pain.

Spinal Cord Stimulation to Treat Unresponsive Cancer Pain: A Possible Solution in Palliative Oncological Therapy

“…Nevertheless, pain is not only related to cancer itself, but it can arise after chemotherapy, surgery, and radiation therapy [8,10,13,[19][20][21].…”

“…Moreover, opioids often fail with neuropathic pain, and long-term opioid therapy is linked to low QoL and life expectancy. In most cases, the use of so-called "invasive" interventional pain procedures can be less invasive than an aggressive medical therapy [10,13,20,72,73]. Therefore, if we consider the longest life expectancy of patients affected by cancer, the costs and side effects of pain drugs (almost all opioids) should be taken into account.…”