Cancer Pain and Neuromodulation

Dr. Jee Youn Moon from Seoul discusses neuromodulation therapy for cancer pain, emphasizing the importance of correct indication and timing. Neuropathic cancer pain—caused by tumor progression, chemotherapy, or radiation—is prevalent, affecting up to 50% of patients. Evidence supports spinal cord stimulation (SCS), DRG stimulation, and peripheral nerve stimulation (PNS) for refractory neuropathic pain, especially in cancer survivors. Neuromodulation should be considered earlier in treatment, even before high-dose opioids, to improve outcomes, reduce opioid use, and enhance quality of life. Alternative modalities like scrambler therapy, electroacupuncture, and sympathetic blocks with botulinum toxin also show promise. Earlier intervention, individualized care, and multimodal strategies are essential.