Implanted Pump Improves Pain Management

A study has demonstrated that an implanted pump that delivers pain medication by slow release into the spinal fluid reduces pain and improves survival in cancer patients, compared to oral painkillers. The study was presented at the annual meeting of the American Society of Clinical Oncology in Orlando (FL, USA).

More than 200 patients with a variety of cancers took part in the study, conducted by researchers at Johns Hopkins (Baltimore, MD, USA; www.hopkinsmedicine.org) and other medical centers. All of the patients had pain that broke through morphine or other opiate drugs. They were randomly assigned to either receive an implantable pump to deliver medication directly into the spinal fluid or to continue taking pain medicine by mouth. At the end of six months, 54% of the pump patients were living vs 37% of those on oral medications. Moreover, the pump patients had less pain and fewer side effects from the pain drugs, less fatigue, less constipation or nausea, and improved mental status.

The pump used in the study is surgically implanted in the abdomen. A small tube from the pump reaches around the waist to deliver medication directly into the spinal fluid. Doctors can tailor the dosage to suit each patient and can refill the pump by injecting medication through the abdomen into a tiny opening on the front of the device. The pump was developed by Medtronic, Inc. (Minneapolis, MN, USA).

"This challenges our thinking about how to treat cancer pain,” said Peter S. Staats, M.D., director of the division of pain medicine at Johns Hopkins and a co-principal investigator for the study. "This suggests that earlier intervention with an approach that minimizes systemic drugs has a significant benefit in a variety of domains.”




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