Open Access Case Report

Successful Multimodality Management of Refractory Cancer Pain on Shoulder Caused by Lung Cancer Metastasis and Resistant to Analgesics: A Case Report

Liya Hu1, Qian Chu2, Yuan Chen2, Peng Zhang2, Lei Zhou2, and Suqiong Ji3*

1Department of Geriatrics, Huazhong University of Science and Technology, China

2Department of Oncology, Hua Zhong University of Science and Technology, China

3Department of Neurology, Hua Zhong University of Science and Technology, China

Corresponding Author

Received Date: February 18, 2020;  Published Date: March 05, 2020


Background: This case describes a successful management of patient suffered from refractory cancer pain and with poor response to any analgesic.

Case Presentation: A 61-year-old woman suffered from severe refractory shoulder pain cause by lung cancer metastasis with bone destruction, pancoast syndrome and local soft tissue invasion. Opioid and other medication is completely ineffective, accompanied with obvious side effect of severe drowsiness.

Case Management: Multiple department treatment (MDT) group were initiate to evaluate the main component of pain and etiological therapy: 1) bone metastases pain; 2) Neuropathic Pain cased by brachial plexus invasion; 3) compression pain associated with soft tissue swelling. Palliative bone radiotherapy, neurosurgical intervention and sodium aescin were successively used due to the patient’s changing symptoms.

Case Outcome: The patient was successfully relived from the pain remission sustained for 5 month. NRS score reduced from 8 to 2 with low dose of opioid and no side effect of drowsiness.

Conclusion: Successful and personalized management of refractory cancer pain depends on the evaluation of changing symptoms, etiology analysis and multidisciplinary teamwork. New approaches are recommended to pain management, especially the axillary nerve pulse radiofrequency surgery.

Keywords: Refractory cancer pain; Pancoast syndrome; Lung cancer; Metastasis; Neuropathic pain; Pain management

Signup for Newsletter
Scroll to Top