Pilot Study of Timely Integration of Interventional Pain Management for Advanced Cancer.

CONTEXT: . Interventional pain procedures, such as such as nerve blocks, neurolytic procedures, and therapeutic injections, can alleviate cancer pain yet are often considered only after failure of high-dose opioids.

OBJECTIVES

. To assess feasibility and acceptability of timely integration of interventional pain management among patients with cancer pain.

METHODS

. This single-arm pilot study enrolled patients with locally advanced or metastatic cancer, moderate-to-severe pain, a prognosis of >6 months, and a daily opioid dose of ≤90 morphine milligram equivalents (MMEs), later amended to ≤200 MMEs). Patients were referred to a pain clinic for systematic consideration of interventional treatments. Surveys at baseline, 2, and 4 months assessed pain (BPI), procedural pain relief (0-100%), and quality of life (QOL; FACT-G). Feasibility and acceptability were evaluated based on time to evaluation, receipt of ≥1 procedure, and satisfaction (0-10). Linear mixed models examined changes in pain and QOL.

RESULTS

. Thirty patients with mixed cancer types were enrolled. Nearly all patients (93%) were evaluated by a pain specialist within four weeks, 56.7% received ≥1 procedure, and 83.3% rated care satisfaction ≥7 (M=8.6; SD=1.6), meeting all feasibility and acceptability benchmarks. Among those who underwent a procedure, patients reported substantial pain relief at both 2 months (M=66.7%, SD=32.8) and 4 months (M=65.3%, SD=34.4). Pain intensity (p=0.015) and pain interference (p=0.03) improved, whereas QOL remained stable (p>0.05).

CONCLUSION

. Timely integration of interventional pain management for cancer pain was feasible and acceptable. Future research should test efficacy and strategies to support integration of procedural pain management into care pathways.