Treatment

Cancer pain management modalities include a combination of medication, procedural interventions, behavioral and physical restorative therapies and other complementary modalities. Treatment strategies considered will depend on the type of pain you are experiencing. Pain relief strategies will differ by patient but may include treating the source of the pain by removing a tumor with surgery or shrinking it with radiation, changing the perception of the pain with medication, and/or interfering with pain signals sent to the brain with spinal treatments or nerve injections.

There are many types of pain, including but not limited to:

• Neuropathic: caused by injury or compression of nerves
• Nociceptive: caused by inflammatory response and tissue damage
• Acute pain: short term, related to specific injury or surgery
• Chronic pain: long term usually longer than 3 months, due to damaged nerves and tissue damage from cancer or cancer related therapy, for example, post radiation/ chemotherapy, injuries or changes to musculoskeletal system. 
• Visceral pain: related to injury or disease of internal organs for example, pain related to pancreatic cancer
• Incidental pain: related to specific movement or event, for example, dressing change or weight bearing

Dependent on your type of pain, general medical state, and ongoing cancer therapy, we will work with you and your medical team to develop a plan that is effective, safe and aligned to your realistic goals and expectations. 

We Offer

• Comprehensive evaluation of pain conditions including its effect on your physical, social, psychological and fiscal well-being.
• Recommendations for opioid and non-opioid medications to help with symptom palliation. In most circumstances your pain can be managed with oral medications and we can continue to oversee your care in collaboration with your primary care team.
• Primary Management: In case of a need for complex medication management our team can take over the medication management until the pain is controlled and then transfer your care to the primary care team.
• Medical Management: oral, IV, topical non-opioids and opioids.
• Specialized medication infusions, for example, lidocaine and ketamine.
• Behavioral therapies
  • Cognitive Behavioral Therapy
  • Acceptance and Commitment Therapy
  • Mindfulness-based stress reduction
  • Emotional awareness and expression Therapy
  • Biofeedback, hypnotherapy and relaxation training
• Procedural interventions
• Restorative therapies
  • Therapeutic exercise
  • Transcutaneous electric nerve stimulation (TENS)
  • Massage therapy
  • Traction
  • Cold and heat
  • Therapeutic ultrasound
  • Bracing

Treatment strategies considered may include:

• Invasive interventions including nerve blocks where medication is injected around a nerve to block the pain transmission temporarily with numbing medication, steroids or permanently with dried alcohol or phenol.
• Neuraxial analgesia: Placing of a catheter in the spinal canal to deliver medication closer to the nerves carrying pain signals to our brain. This modality can be a temporary intervention while you are in the hospital or a destination therapy where you go home with a totally implanted device.
• Injection of cement or ablative therapies to help with pain from vertebral body fractures.
• Restorative therapies to optimize your physical function by working with Physical and Occupational therapists.
• Optimization of self-management and coping strategies with behavioral medicine.
• Complementary therapies like acupuncture and massage are available with outside consultation.