Access to interventional therapies for cancer pain: An exploratory survey of cancer pain experts

TL;DR

This study explores how cancer pain specialists access and use interventional therapies, finding that complex procedures are less accessible and availability varies by cancer type and setting.

Contribution

The study identifies specific interventional therapies with limited access and highlights how procedural complexity and institutional resources affect cancer pain management.

Findings

Cancer pain experts reported limited access to complex procedures like SCS, ITDD, and cordotomy.

Availability of therapies varied by cancer type and clinical setting, with academic centers lacking complementary therapies.

Institutional resources and practice settings significantly influence access to and use of interventional pain treatments.

Abstract

The substantial health burdens and prevalence of cancer-related pain both during and after treatment underscore the need for expanded access to cancer pain specialists and therapeutic pain treatments. Despite growing demand, cancer pain specialists face substantial barriers to providing effective care.

This exploratory study sought to characterize perspectives from a small group of international pain experts to examine patterns of utilization and perceived accessibility of interventional therapies across cancer types and clinical practice settings.

An international, anonymous survey of cancer pain experts, identified via rigorous definition criteria, was conducted using the Qualtrics platform. The survey evaluated eight cancer-related pain categories: head and neck cancer, pleural and rib-based lung cancer, pancreatic cancer, pelvic cancer, lumbosacral spine cancer, extremity cancer, chemotherapy-induced peripheral neuropathy, and bone metastases. Respondents were asked to indicate which treatments they currently use for each type of cancer and which they would use if they had access to them.

Cancer pain experts reported limited access to procedures with greater complexity. Some procedures had substantial variability in use and accessibility, specifically SCS, ITDD, permanent PNS, and nucleus tractus cordotomy. Complementary and alternative therapies were desirable but largely unavailable, particularly in academic settings.

Despite the growing need for cancer pain management, specialists continue to face substantial barriers to delivering effective care. This exploratory survey of cancer pain experts identified patterns of reported use and access limitations for therapies across cancer types and practice settings. These findings suggest a relationship between procedural complexity and access barriers, with utilization and availability shaped by institutional resources and practice settings.

Figures