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Management of metastatic bone pain on May 7, 2021 at 9:07 am
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    • AMIT
      Joined: Jun 29, 2018
      Posts: 2

      I work as a pain physician in a cancer hospital. I frequently come across a certain subset of patients whose pain is very resistant to conventional therapies. Most often in metastatic carcinoma Prostate who’ve already received multiple lines of chemo, bisphosphonates, even palliative RT ( radiation).
      They do respond to NSAIDs but the fear of long term consequences prevents me from prescribing them for anything but short spells or acute exacerbations.
      I’d like to know if epidural particulate steroids would be of use in vertebral mets ( mainly the sclerotic kind which don’t respond to RT)
      Also, pelvic bony mets severely restrict my patients’ mobility which is very distressing for them ( and for me too!)
      would be much obliged for expert advice on management of such patients.
      Intrathecal pumps are not feasible in my part of the world ( India) due to their prohibitive cost and almost 95% of my patients aren’t covered by insurance.

      • Jamal AhmedJamal Ahmed
        Joined: Oct 25, 2017
        Posts: 4

        for pelvic pain try to do superior hypogastric plexus diagnostic block with local anesthetic and if it was positive go for neurolysis with alcohol or phenol

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