Skip to main content
SpringerLink
Log in

Gastrointestinal Cancer Pain

  • Chapter
  • First Online:
Essentials of Interventional Cancer Pain Management

Abstract

Many varied pain treatment options exist for pain syndromes secondary to gastrointestinal malignancies and its associated treatments. Systemic therapy using the WHO analgesic ladder is a reasonable initial choice even for practitioners without special training in pain management. Unfortunately, many of these medications are either insufficient when used as monotherapy or associated with intolerable medication-related adverse side effects. In the sections below, we will focus on some techniques that may be considered for common pain syndromes associated with gastrointestinal malignancies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 149.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 199.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Chiu TY, Hu WY, Chen CY. Prevalence and severity of symptoms in terminal cancer patients: a study in Taiwan. Support Care Cancer Off J Multinatl Assoc Support Care Cancer. 2000;8:311–3.

    CAS  Google Scholar 

  2. Daut RL, Cleeland CS. The prevalence and severity of pain in cancer. Cancer. 1982;50:1913–8.

    Article  CAS  Google Scholar 

  3. Donnelly S, Walsh D, Rybicki L. The symptoms of advanced cancer: identification of clinical and research priorities by assessment of prevalence and severity. J Palliat Care. 1995;11:27–32.

    CAS  PubMed  Google Scholar 

  4. Portenoy RK, et al. Pain in ovarian cancer patients. Prevalence, characteristics, and associated symptoms. Cancer. 1994;74:907–15.

    Article  CAS  Google Scholar 

  5. Vainio A, Auvinen A. Prevalence of symptoms among patients with advanced cancer: an international collaborative study. J Pain Symptom Manag. 1996;12:3–10.

    Article  CAS  Google Scholar 

  6. Greenwald HP, Bonica JJ, Bergner M. The prevalence of pain in four cancers. Cancer. 1987;60:2563–9.

    Article  CAS  Google Scholar 

  7. Bruera E, Portenoy R (eds.). Cancer pain assessment and management. Cambridge UK: Cambridge University Press; 2009. ISBN: 978-0521879279

    Google Scholar 

  8. Sykes N, Bennet M, Yuan C. Clinical pain management. 2nd Edition. Cancer Pain. Boca Raton, FL: CRC Press; 2008. ISBN: 978-0340940075.

    Google Scholar 

  9. Grahm AL, Andrén-Sandberg A. Prospective evaluation of pain in exocrine pancreatic cancer. Digestion. 1997;58:542–9.

    Article  CAS  Google Scholar 

  10. Deraco M, Laterza B, Kusamura S, Baratti D. Updated treatment of peritoneal carcinomas: a reviewMinerva Chir. 2007;62:459–76.

    CAS  PubMed  Google Scholar 

  11. Suzuki M, et al. Sensation of abdominal pain induced by peritoneal carcinomatosis is accompanied by changes in the expression of substance P and μ-opioid receptors in the spinal cord of mice. Anesthesiology. 2012;117:847–56.

    Article  CAS  Google Scholar 

  12. Russo P. Urologic emergencies in the cancer patient. Semin Oncol. 2000;27:284–98.

    CAS  PubMed  Google Scholar 

  13. Nduka CC, Monson JRT, Menzies-Gow N, Darzi A. Abdominal wall metastases following laparoscopy. Br J Surg. 1994;81:648–52.

    Article  CAS  Google Scholar 

  14. Foley KM. Pain syndromes in patients with cancer. Med Clin North Am. 1987;71:169–84.

    Article  CAS  Google Scholar 

  15. Borad MJ, et al. Skeletal metastases in pancreatic cancer: a retrospective study and review of the literature. Yale J Biol Med. 2009;82:1–6.

    CAS  PubMed  PubMed Central  Google Scholar 

  16. Ahn JB, Ha TK, Kwon SJ. Bone metastasis in gastric cancer patients. J Gastric Cancer. 2011;11:38–45.

    Article  Google Scholar 

  17. Roth ES, et al. Does colon cancer ever metastasize to bone first? A temporal analysis of colorectal cancer progression. BMC Cancer. 2009;9:274.

    Article  Google Scholar 

  18. Santini D, et al. Natural history of bone metastasis in colorectal cancer: final results of a large Italian bone metastases study. Ann Oncol Off J Eur Soc Med Oncol ESMO. 2012;23:2072–7.

    Article  CAS  Google Scholar 

  19. Brihaye J, Ectors P, Lemort M, Van Houtte P. The management of spinal epidural metastases. Adv Tech Stand Neurosurg. 1988;16:121–76.

    Article  CAS  Google Scholar 

  20. Mercadante S, Villari P, Ferrera P, Arcuri E, David F. Opioid switching and burst ketamine to improve the opioid response in patients with movement-related pain due to bone metastases. Clin J Pain. 2009;25:648–9.

    Article  Google Scholar 

  21. Luger NM, et al. Efficacy of systemic morphine suggests a fundamental difference in the mechanisms that generate bone cancer vs inflammatory pain. Pain. 2002;99:397–406.

    Article  CAS  Google Scholar 

  22. Quasthoff S, Hartung HP. Chemotherapy-induced peripheral neuropathy. J Neurol. 2002;249:9–17.

    Article  CAS  Google Scholar 

  23. Boelens OB, Scheltinga MR, Houterman S, Roumen RM. Management of anterior cutaneous nerve entrapment syndrome in a cohort of 139 patients. Ann Surg. 2011;254:1054–8.

    Article  CAS  Google Scholar 

  24. Akhnikh S, de Korte N, de Winter P. Anterior cutaneous nerve entrapment syndrome (ACNES): the forgotten diagnosis. Eur J Pediatr. 2014;173:445–9.

    Article  Google Scholar 

  25. Kinsella TJ, et al. Threshold dose for peripheral neuropathy following intraoperative radiotherapy (IORT) in a large animal model. Int J Radiat Oncol. 1991;20:697–701.

    Article  CAS  Google Scholar 

  26. Yi SK, et al. Development of a standardized method for contouring the lumbosacral plexus: a preliminary dosimetric analysis of this organ at risk among 15 patients treated with intensity-modulated radiotherapy for lower gastrointestinal cancers and the incidence of radiation-induced lumbosacral plexopathy. Int J Radiat Oncol Biol Phys. 2012;84:376–82.

    Article  Google Scholar 

  27. Wj M. Surgical management of radiation enteropathy. Surg Clin North Am. 1991;71:977–90.

    Article  Google Scholar 

  28. Eisenberg E, Carr DB, Chalmers TC. Neurolytic celiac plexus block for treatment of cancer pain: a meta-analysis. Anesth Analg. 1995;80:290–5.

    CAS  PubMed  Google Scholar 

  29. Polati E, et al. Prospective randomized double-blind trial of neurolytic coeliac plexus block in patients with pancreatic cancer. Br J Surg. 1998;85:199–201.

    Article  CAS  Google Scholar 

  30. Rykowski JJ, Hilgier M. Efficacy of neurolytic celiac plexus block in varying locations of pancreatic cancer: influence on pain relief. Anesthesiology. 2000;92:347–54.

    Article  CAS  Google Scholar 

  31. Cameron T. Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review. J Neurosurg Spine. 2004;100:254–67.

    Article  Google Scholar 

  32. Kapural L, Rakic M. Spinal cord stimulation for chronic visceral pain secondary to chronic non-alcoholic pancreatitis. J Clin Gastroenterol. 2008;42:750–1.

    Article  Google Scholar 

  33. Kim JK, Hong SH, Kim M-H, Lee J-K. Spinal cord stimulation for intractable visceral pain due to chronic pancreatitis. J Korean Neurosurg Soc. 2009;46:165.

    Article  Google Scholar 

  34. Khan YN, Raza SS, Khan EA. Application of spinal cord stimulation for the treatment of abdominal visceral pain syndromes: case reports. Neuromodulation Technol Neural Interface. 2005;8:14–27.

    Article  Google Scholar 

  35. Saito O, et al. Ketamine and N-acetylaspartylglutamate peptidase inhibitor exert analgesia in bone cancer pain. Can J Anaesth J Can Anesth. 2006;53:891–8.

    Article  Google Scholar 

  36. Jackson K, et al. Burst’ ketamine for refractory cancer pain: an open-label audit of 39 patients. J Pain Symptom Manag. 2001;22:834–42.

    Article  CAS  Google Scholar 

  37. Mercadante S, Villari P, Ferrera P. Burst ketamine to reverse opioid tolerance in cancer pain. J Pain Symptom Manag. 2003;25:302–5.

    Article  Google Scholar 

  38. Mercadante S, Arcuri E, Tirelli W, Casuccio A. Analgesic effect of intravenous ketamine in cancer patients on morphine therapy: a randomized, controlled, double-blind, crossover, double-dose study. J Pain Symptom Manage. 2000;20:246–52.

    Article  CAS  Google Scholar 

  39. Patil S, Anitescu M. Efficacy of outpatient ketamine infusions in refractory chronic pain syndromes: a 5-year retrospective analysis. Pain Med Malden Mass. 2012;13:263–9.

    Article  Google Scholar 

  40. Kosharskyy B, Almonte W, Shaparin N, Pappagallo M, Smith H. Intravenous infusions in chronic pain management. Pain Physician. 2013;16:231–49.

    PubMed  Google Scholar 

  41. Day M. Sympathetic blocks: the evidence. Pain Pract Off J World Inst Pain. 2008;8:98–109.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Massachusetts General Hospital, Boston, MA, USA

    Daniel Pak

  2. Memorial Sloan Kettering Cancer Center, Anesthesiology and Critical Care Medicine, New York, NY, USA

    Joseph C. Hung

Authors
  1. Daniel Pak
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Joseph C. Hung
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Joseph C. Hung .

Editor information

Editors and Affiliations

  1. Department of Anesthesiology and Critical Care, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Amitabh Gulati

  2. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Vinay Puttanniah

  3. Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA

    Brian M. Bruel

  4. Midwest Neuroscience Institute, Center for the Relief of Pain, Kansas City, MO, USA

    William S. Rosenberg

  5. Anesthesiology and Critical Care Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Joseph C. Hung

Rights and permissions

Reprints and permissions

Copyright information

© 2019 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Pak, D., Hung, J.C. (2019). Gastrointestinal Cancer Pain. In: Gulati, A., Puttanniah, V., Bruel, B., Rosenberg, W., Hung, J. (eds) Essentials of Interventional Cancer Pain Management. Springer, Cham. https://doi.org/10.1007/978-3-319-99684-4_11

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-99684-4_11

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-99682-0

  • Online ISBN: 978-3-319-99684-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation