Management of cancer pain: different intervention techniques

A considerable number of patients with cancer suffer considerable pain during their disease. Most of these patients achieve analgesia using opioids and adjuvant medication; however, 5-10% of them still experience inadequate pain control despite aggressive combined pharmacological therapy and their use is often associated with adverse events. Providing effective pain management for patients with severe pain that affects quality of life confronts the oncologist or pain specialist with clinical challenges that often require multifaceted therapeutic measures. Interventional pain therapies are a diverse set of procedural techniques for controlling pain that may be useful when systemic analgesics failed to provide adequate control of cancer pain or when the adverse effects cannot be managed reasonably. Commonly used interventional therapies for cancer pain include neuroaxial, neurolytic including sympathetic block and paravertebral block ; in addition, neurosurgical procedures are used as last rescue once other techniques failed in order to achieve the highest possible success while minimizing potential complications and side effects. The intent of alternative therapies is to provide adequate and effective pain management in the oncology and palliative care arena with improvement in patient quality of life.