Introduction to Neurosurgical Treatment of Cancer Pain

Most patients with pain from cancer do not require neurosurgical procedures. After a thorough diagnostic evaluation and treatment with appropriate surgery, radiotherapy, or chemotherapy, patients who continue to have pain are managed with medication. If milder analgesics are not adequate, narcotics are given and increased in dose and frequency according to pharmacokinetic principles outlined in Chapter 20. For patients who continue to have incapacitating pain, neurosurgical intervention may be beneficial. This is offered to patients who cannot be managed with oral narcotics because of inadequate analgesia, unacceptable mental impairment, nausea, or vomiting.