TUESDAY, May 21, 2002 (HealthDayNews) -- An implantable pump that delivers pain medicine into the spinal fluid of cancer patients improves their pain control and quality of life, and -- as an added bonus -- it may increase their survival rates.
The pump was the focus of an international study that included more than 200 people with a variety of cancers -- including lung, breast, colon, prostate and pancreatic cancers -- whose pain could not be controlled by morphine or opiate drugs.They were randomly assigned to receive either the pump or to continue taking medications by mouth. At the end of the six-month study, 54 percent of the pump patients were alive, compared to 37 of the other patients. The patients with the pump had less pain and fewer side effects from pain drugs -- including less fatigue, constipation or nausea, and improved mental status.
While the scientists still have to determine why the survival rate was dramatically higher, Dr. Peter S. Staats, the study's principal investigator and director of the division of pain medicine at Johns Hopkins Medical Institutions, did draw some conclusions: "Normally we give the patients pain medication, and if it doesn't work we'll resort to something else as a last-ditch effort.
"This suggests that earlier intervention with an approach that minimizes systemic drugs has a significant benefit in a variety of domains. It presents a whole new paradigm in patient care."
The study was done at 27 medical centers, including Johns Hopkins and the Medical College of Virginia. The results were presented today at the annual meeting of the American Society of Clinical Oncology in Orlando, Fla.
The pump is about the size and shape of a hockey puck. It holds a prescribed amount of pain drug and is surgically inserted into the abdomen. A small tube runs from the pump and carries the medicine into the spinal fluid.
Drug doses can be tailored to each patient, and the pump is refilled by injecting medication through the patient's abdomen into a tiny opening at the front of the pump.
Doctors have been wrestling with the intricacies of pain management for the very ill for some time. The National Pain Foundation offers information into all sorts of pain management, from muscle soreness to constant migraine headaches.