From Cancer Treatment to Cancer Survivorship: A Case Report Demonstrating the Dynamic Roles of Intrathecal Drug Delivery System in Various Phases of Cancer Care

Abstract

Background: Until the continued improvements in cancer diagnosis and treatment, many cancers were once considered terminal illnesses. Opioid-based therapy is frequently utilized from the armamentarium for cancer pain treatment since the immediate goals of acute cancer pain management are focused on alleviating pain severity and improving quality of life during this limited time – despite the risks of chronic opioid therapy. However, now, with an expanding cancer survivor population, we lack guidance and tools to assist health care providers and patients in pivoting the focus of cancer pain management from acute relief toward improving function, rehabilitation, and limiting the long-term adverse effects of pain and opioid therapy. Case Report: Here, we present a case exemplifying the ability of intrathecal drug delivery systems to serve a multitude of roles during the various phases of cancer care: from treating acute cancer-related pain, acting as a tool to wean systemic opioid therapy, to being clinically dormant in situ but ready to serve again in the event of cancer recurrence. Conclusion: Intrthecal drug delivery systems are effective tools in managing acute cancer pain and can also be adapted to help manage chronic pain in cancer survivors. Key words: Cancer pain, intrathecal drug delivery system, intrathecal pump, opioid weaning