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B390 Developing a multi-disciplinary service for neuromodulation and neuroablative surgical treatments for cancer pain
  1. JS Malik1,
  2. M Hart2,
  3. A Mostofi2,
  4. J Williams1,
  5. R Gordon-Williams1,
  6. J Schutzer-Weissmann1,
  7. M Macdonald2,
  8. E Pereira2 and
  9. M Brown1
  1. 1Pain Medicine Department, The Royal Marsden Hospital, London, UK
  2. 2St George’s, University of London and St George’s University Hospital, London, UK


Background and Aims Cancer pain services have been adversely impacted by Covid-19. Patients are experiencing disruptions and delays in their treatment, leading to cancer progression and an increased need for more advanced pain interventions.

To address this, we developed a multi-specialty neuromodulation and neuroablation service comprising a monthly clinic of pain and neurosurgery consultants and nurse specialists and weekly multi-discipilinary team meeting to optimise the provision of advanced treatments for cancer pain.

We retrospectively evaluated patients referred to our service with an aim to select those patients with a worse prognosis earlier to maximise their benefit from such treatments (Figure 1).

Methods 58 patients were reviewed in the clinic over an 18-month period. This included a range of oligometastatic (79%) and polymetastatic (21%) presentations.

Cancer treatments such as radiotherapy and chemotherapy were outlined as well as the current analgesia patients were using to manage their pain.

A composite body map was generated, summarising the frequency of pain reports at different anatomical locations (Figure 2).

Results 81% trialled anti-neuropathic agents and 58% anti-depressants. 29% of patients had an opioid consumption of greater than the maximum oral equivalent of morphine recommended by the British Pain Society (>120mg/daily). 74% patients were selected for advanced pain management procedures.

Conclusions Our data highlights the need and utility of a multi-specialty neuromodulation and neuroablative cancer pain service, which aligns with the recommendations made in the recently published Framework for Provision of Pain Services for Adults Across the UK with Cancer or Life-limiting Disease.

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