Practical Management of Complex Cancer Pain

This new edition of the Practical Management of Complex Cancer Pain has been fully updated and expanded, with five new chapters on novel interventional techniques in cancer pain amelioration. The book provides advice on advanced pain management, emphasising the suitability and selection of patients for different invasive and complex procedures based on patient history.

Case histories are included throughout the text to give the reader insight into the complexities of holistic management, with pain being only one component in the distress that cancer causes for both patients and families. The book also covers cancer pain management for patients in a community setting, and the collaboration between pain and palliative medicine.

Concise, practical, and evidence-based, this guide is essential reading for all pain and palliative care specialists in the community, hospital, and hospice settings.

Manohar Sharma, Consultant in Pain Medicine, The Walton Centre NHS Foundation Trust Liverpool, UK,Karen H. Simpson, Honorary Consultant in Anaesthesia and Pain Medicine, Leeds Teaching Hospitals NHS Trust and Senior Clinical Lecturer, University of Leeds, Leeds, UK,Michael I. Bennett, Professor of
Palliative Medicine, Leeds Institute of Health Sciences University of Leeds Leeds, UK,Sanjeeva Gupta, Consultant in Anaesthesia and Pain Medicine, Bradford Royal Infirmary Bradford, UK

Dr Manohar Sharma as a Consultant in Pain Medicine has been treating patient requiring advanced pain management techniques with in MDT set up over the last 16 year. He has been performing advanced pain techniques including cervical cordotomy and has published his own prospective outcome data as well
as national cordotomy registry data. He has developed educational courses for European Pain Federation and in Liverpool to promote high quality pain management with in MDT set up. His other pain interests include interventional pain treatments including neuromodulation and trigeminal neuralgia
interventions which he has widely published and promoted in his educational activities.


Dr Karen H. Simpson graduated from the School of Medicine at Leeds, UK in 1979. She met some very inspirational teachers in pain management during her undergraduate anaesthesia training in Leeds and Bradford. As a trainee she was seconded to the School of Pharmacy in Bradford University where she
did basic science research. She started pain training in 1981 under the supervision of Dr Keith Budd who remained her mentor throughout her career.
As well as working within a large multi-professional Pain Management Service, she has a special interest in palliative medicine. She was chairman of the Regional Palliative Medicine Training Committee and she established Palliative Medicine training in Yorkshire. She was an Honorary Consultant at
St Gemma's Hospice, Leeds. She retired from the NHS in 2016 and is now in private practice. She was a founder member of the Leeds Pallium Research Group. She was an FRCA examiner for 12 years.

Mike Bennett is the St Gemma's Professor of Palliative Medicine and is Director of the Academic Unit of Palliative Care. The Academic Unit is an internationally recognized multidisciplinary research and teaching unit based at the University of Leeds and St Gemma's Hospice, UK with 27 staff. In 2017,
he secured formal University Teaching Hospice status for St Gemma's Hospice (first in the UK) where he works clinically 1 day per week. His main research interests are in cancer pain and neuropathic pain, and evaluating interventions at the end of life. Since taking up his post in Leeds, he has
generated over ?2.8m in research grants and awards. He has published over 230 papers in scientific journals resulting in H-index of 44 (Scopus). He led the writing of Core Standards for Cancer Pain which are now adopted into the NHS and form part of the CQC inspection framework, and led the writing
of the cancer pain taxonomy for ICD-11 as part of the IASP task force.

Dr Sanjeeva Gupta completed his basic medical degree in 1988 from Mysore (South India) and was awarded MD (Anaesthesia) from the Postgraduate Institute of Medical Education and Research, a Premier Institute in Chandigarh, India.

He trained at Belfast, Oxford and Cambridge and was appointed as a Consultant in Anaesthesia and Pain Medicine at the Bradford Teaching Hospitals in 1999. Sanjeeva passed an examination in 2004 to be awarded Fellow of Interventional Pain Medicine (FIPP) by the World Institute of Pain, USA. He was
awarded the Fellow of the Faculty of Pain Medicine in 2007.

Currently Sanjeeva is a full-time consultant in Pain Medicine at the Bradford Teaching Hospitals NHS Foundation Trust.

A. Introduction and clinical cases
1. Definition and pathophysiology of complex cancer pain, Michael Bennett
2. Evidence based pharmacological approaches to management, Michael Bennett and Paul Farquhar Smith
3. Neurolytic blocking agents, Mahesh Choudhary
4. Role of surgery in cancer pain management, Paul Eldridge and Deepti Bhargava
5. Oncological management of cancer pain, Chinnamani Eswar
6. Pelvic pain, Arun Bhaskar
7. Chest wall pain from mesothelioma or lung cancer, Manohar Sharma, Sanjeeva Gupta, and Lakshmi Vas
8. Unilateral upper limb plexopathy pain caused by cancer, Lakshmi Vas
9. Unilateral lower limb plexopathy related cancer pain, Kate Marley
10. Upper GI pain from invasive pancreatic cancer, Hemkumar Pushparaj
11. Multiple bone metastases/bone fracture related, Manohar Sharma and Sanjeeva Gupta
12. Intrathecal pump case history, JJohn Titterington, Louise Lynch, and Hemkumar Pushparaj
13. Cancer survivor with pain progression, Kate Marley and Manohar Sharma
B. Details of interventional techniques
14. Basic procedure safety and patient considerations for cancer pain interventions, Samyadev Datta
15. Sympathectomy for cancer pain, Dhanalakshmi Koyyalagunta and Arun Bhaskar
16. Kyphoplasty and vertebroplasty for spinal metastasis pain, Kumar S V Das and Shubhabrata Biswas
17. Cervical cordotomy (Fluroscopic and CT Guided technique), Manohar Sharma and Ashwin Vishwanathan
18. Intrathecal drug delivery for cancer pain, John Titterington
19. Spinal neurolysis, Mahesh Chaudhari
20. Interventions for head and neck cancer related pain, Manohar Sharma and Lakshmi Vas
21. Neurosurgical techniques for cancer pain, Paul Eldridge and Deepti Bhargava
23. Spinal cord stimulation for cancer related pain, Dmitry Kruglov and Simon Thomson
24. Radiological tumour ablative techniques, Gaurav Sundar
25. Radiofrequency brain lesioning for cancer related pain, Erlick Pereira and Abteen Mostafi
26. Radiofrequency ablation technique for metastatic spine disease, Samyadev Datta
27. The role of High Intensity Focused Ultrasound (HIFU) in cancer pain management, Mathew Brown
C. Collaboration between services
28. Role of collaboration between pain medicine and palliative care, Kate Marley and Hemkumar Pushparaj
29. Pain in cancer survivors, Mathew Brown
30. Control of complex pain at the end of life in hospice or community setting, Eugene Choi, Priya Krishaswamy, and Umesh K. Gidwani