• David J Magee, John Schutzer-Weissmann, PereiraErlick A CEACNeurosciences Research Centre, Molecular and Clinical Sciences Institute, St George's, University of London.Department of Neurosurgery, St George's University Hospital., and BrownMatthew R DMRDPain Medicine Department, The Royal Marsden Hospital.Targeted Approaches to Cancer Pain Group, The Institute of Cancer Research, London, UK..
• Signalling and Cancer Metabolism Team, Division of Cancer Biology, The Institute of Cancer Research.
• Curr Opin Support Palliat Care. 2021 Jun 1; 15 (2): 77-83.

Purpose Of ReviewAdvanced pain management techniques may be indicated in 5-15% of cancer patients. Despite this, a recent review identified that, over the course of 1 year in England, only 458 patients received a procedure intended to provide analgesia and only 30 patients had intrathecal drug delivery (ITDD) devices implanted. This article describes the emerging evidence for ITDD in cancer pain and provides a narrative review of other neuromodulatory techniques (including spinal cord stimulation, peripheral nerve stimulation and acupuncture), approaches that might be employed to address this area of significant unmet clinical need.Recent FindingsNumerous studies have been published within the last year reporting positive outcomes associated with ITDD in cancer pain management. Neuromodulation represents an important strategy in the management of persistent pain. Whilst the nonmalignant pain evidence-base is rapidly growing, it remains sparse for cancer pain management. The growing cohort of cancer survivors may significantly benefit from neuromodulatory techniques.SummaryITDD and other neuromodulatory techniques for cancer pain management appear underutilised in the UK and offer the prospect of better treatment for cancer patients with refractory pain or intolerable side-effects from systemic analgesics.Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.

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