Journal of Pain Management & Medicine

Abstract

EXPLORING INTRATHECAL THERAPY IN CANCER PAIN: A REVIEW WITH CASE STUDY PERSPECTIVES

Vahid Mohabbati*, Parsa Mohabbati and Mohammadkazem Papan

Background: Intrathecal therapy, involving the direct administration of medications into the spinal canal, presents a targeted approach for managing diverse medical conditions, particularly cancer-related pain and neurological disorders. This review explores the historical evolution, rationale and efficacy of intrathecal therapy across various medical contexts and cancer pain. 

Objectives: Beginning with a definition and mechanistic overview, the review demonstrates the localized drug delivery advantages of intrathecal therapy. It traces the historical trajectory, from early use of intrathecal morphine and baclofen to contemporary intrathecal drug delivery systems, highlighting the foundational studies that propelled its development. Central to the review is the examination of intrathecal therapy’s role in cancer pain management. Emphasizing the multidimensional impact of cancer-related pain, the review evaluates evidence supporting the superiority of intrathecal opioids and non-opioids over conventional delivery methods. Despite its proven efficacy, barriers to wider acceptance and utilization in refractory cancer pain management are discussed. 

Methods: We present a series of case studies showcasing the clinical utility and therapeutic efficacy of IDDS in managing complex cancer-related pain. Each case highlights the role of intrathecal therapy in optimizing pain management, improving functionality and enhancing quality of life.

Results: All patients experienced meaningful pain relief and enhanced quality of life with intrathecal therapy. Common adverse effects, including pruritus and nausea, were managed effectively through dose adjustments and adjunctive treatments. The interventions also reduced hospital admissions, allowing patients to spend more time in community settings. 

Conclusion: Intrathecal analgesia offers a valuable alternative for patients with refractory cancer pain, addressing the limitations of systemic therapies. Tailored intrathecal interventions, supported by multidisciplinary care, can achieve optimal pain control, improve functionality and enhance patient comfort in advanced disease stages.

Published Date: 2025-02-26; Received Date: 2025-01-23