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Questions and Answers – Drug Pumps

Cancer Pain

Does more pain mean my cancer has gotten worse?

Not necessarily. You will need to discuss this with your doctor. Regardless of the stage of your cancer, the right treatment to relieve cancer pain may improve your quality of life.

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What is an intrathecal drug pump?

An intrathecal drug pump (targeted drug delivery) is designed to manage pain by delivering pain medicine directly to the intrathecal space, where fluid flows around the spinal cord. Unlike oral medication that must circulate throughout your bloodstream, drug delivery therapy delivers medicine to the site of action, so pain symptoms can be controlled with a small fraction of the oral dose. Most people also experience fewer or more tolerable side effects, such as nausea and constipation, due to negligible levels of pain medication in the bloodstream.1-3

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How does a drug pump work?

When the pump and catheter release prescribed amounts of pain medication directly to the receptors near the spine, it interrupts the pain signals before they reach the brain. You return to your refill clinic for more medication when the pump needs to be refilled.

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Is a drug pump right for me?

Talk with your doctor to determine what kinds of pain treatments may work for you. The choice of treatment depends on the type of pain, how severe it is, and how you respond. If your doctor thinks you are a good candidate for a drug pump, you can undergo a trial. The trial serves as a temporary evaluation period so you can see if targeted drug delivery relieves your pain before committing to long-term therapy.

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Is the pump new?

No. Medtronic implantable pumps have been available since 1991.

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Will drug delivery treatment completely eliminate my pain?

Many people experience improvements in their pain symptoms1,2,4-6 and quality of life1,2,4,7-9 after receiving Medtronic drug delivery therapy. However, realistic expectations are essential to satisfaction with any pain treatment. Drug delivery therapy cannot eliminate the source of your pain or cure any underlying disease, but it may help you to better manage your pain.

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Isn't it easy to become addicted to pain medication?

This is a common misperception. In fact, medical research shows the chance of an individual with cancer pain becoming addicted to pain relieving drugs is extremely small.

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Will the drug pump eliminate other sources of pain?

Your pump will typically not provide relief from other types of pain such as headaches, stomachaches, fractures, etc.

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What is the surgery like?

The surgery to implant the system takes approximately 1 to 3 hours and is typically performed under general anaesthesia. The length of your hospital stay will vary depending on your doctor’s preference and hospital procedures.Talk with your doctor for more information about the potential risks from the surgical procedure.

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What do I need to know about morphine used in my pump?

There are risks associated with the use of morphine. For more details, see the morphine question and answer sheet.

References

1

Smith TJ, Staats PS, Deer T, et al. Randomized clinical trial of an implantable drug delivery system compared with comprehensive medical management for refractory cancer pain: impact on pain, drug-related toxicity, and survival. J Clin Oncol. 2002;20:4040-4049.

2

Hamza M, Doleys D, Wells M, et al. Prospective study of 3-year follow-up of lowdose intrathecal opioids in the management of chronic nonmalignant pain. Pain Med. 2012;13:1304-1313.

3

Ruan X. Drug-related side effects of long-term intrathecal morphine therapy. Pain Physician. 2007;10:357-366.

4

Deer T, Chapple I, Classen A, et al. Intrathecal drug delivery for treatment of chronic low back pain: report from the National Outcomes Registry for Low Back Pain. Pain Med. 2004;5:6–13.

5

Ellis DJ, Dissanayake S, McGuire D, et al. Continuous intrathecal infusion of ziconotide for treatment of chronic malignant and nonmalignant pain over 12 months: a prospective, open-label study. Neuromodulation. 2008;11:40-49.

6

Duarte RV, Raphael JH, Sparkes E, Southall JL, LeMarchand K, Ashford RL. Long-term intrathecal drug administration for chronic nonmalignant pain. J Neurosurg Anesthesiol. 2012;24:63-70.

7

Winkelmüller M, Winkelmüller W. Long-term effects of continuous intrathecal opioid treatment in chronic pain of nonmalignant etiology. J Neurosurg. 1996;85:458-67.

8

Roberts LJ, Finch PM, Goucke CR, Price LM. Outcome of intrathecal opioids in chronic non-cancer pain. Eur J Pain. 2001;5: 353-361.

9

Thimineur MA, Kravitz E, Vodapally MS. Intrathecal opioid treatment for chronic non-malignant pain: a 3-year prospective study. Pain. 2004;109:242-249.

Next: Getting a Drug Pump

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Information on this site should not be used as a substitute for talking with your doctor. Always talk with your doctor about diagnosis and treatment information.