humburger icon

Spinal Analgesia in Cancer Pain Management – MASCC General Practice Recommendations

Home > News > Spinal Analgesia in Cancer Pain Management – MASCC General Practice Recommendations
New Guidelines and Guideline Summaries

Spinal Analgesia in Cancer Pain Management – MASCC General Practice Recommendations

New MASCC recommendations on spinal analgesia for cancer pain have just been published in Supportive Care in Cancer.

Cancer pain that doesn’t respond to conventional therapies remains a major challenge in palliative care. A newly published expert consensus from our Palliative Care Study Group and Cancer Pain Subgroup provides practice-oriented guidance on the use of spinal analgesia for refractory cancer pain.

Key Takeaways Include:

  • Spinal therapy, particularly via the intrathecal (IT) route, should be considered in cases of refractory cancer pain.
  • Morphine and hydromorphone are the opioids of choice for IT therapy and may be enhanced with local anesthetics.
  • Use of ziconotide, though requiring careful titration, avoids tolerance and dependence.
  • A conversion ratio of 100:1 between oral and IT morphine is suggested for patients who receive high doses of systemic opioids.
  • Choice of implantable systems (IDDS or Port-a-Cath) should align with patient prognosis and individual needs.
  • The decision-making process for employing therapies like spinal analgesia should be shared, taking into account the actual indications and needs, previous treatments, prognosis, timing, advantages, disadvantages, and potential complications.
  • All
  • Affiliates & Partners
  • Announcements
  • Annual Meeting
  • Centers of Excellence
  • Research Highlights