Recently Diagnosed or Relapsed? Stop Looking For a Miracle Cure, and Use Evidence-Based Therapies To Enhance Your Treatment and Prolong Your Remission
Multiple Myeloma an incurable disease, but I have spent the last 25 years in remission using a blend of conventional oncology and evidence-based nutrition, supplementation, and lifestyle therapies from peer-reviewed studies that your oncologist probably hasn't told you about.
Click the orange button to the right to learn more about what you can start doing today.
Neurosurgical options for myeloma pain are underutilized, according to the Mayo Clinic article linked below. My eye was drawn to the article below because of my own therapy-induced pain.
Also, I spend a fair amount of time in online MM groupswhere countless posts from MM patients and survivors ask for feedback about pain relief.
When I asked ChatGPT for neurosurgical options for myeloma pain, I was floored by the list below. I haven’t even heard of some of the pain management methods below.
At 36 minutes, the video below is longer than I’d like. However, the doctor speaking does a great job of explaining “pain” and then different surgical therapies to manage pain.
Neurosurgical Options for Controlling Cancer Pain
Below is an overview of the most common neurosurgical (and neurosurgery-led interventional) pain management methods used for multiple myeloma survivors, especially when pain is chronic, refractory to medications, or related to spine/nerve involvement. These are typically considered after medical oncology and conservative pain management options have been tried and are individualized based on disease status and imaging.
1. Vertebral Augmentation Procedures
Most common neurosurgical interventions in myeloma survivors
• Vertebroplasty
Injection of bone cement into fractured vertebrae
Rapid pain relief
Improves stability
• Kyphoplasty
Balloon-assisted version of vertebroplasty
Can restore vertebral height
Often preferred if deformity or kyphosis is present
Used for:
Myeloma-related compression fractures
Mechanical back pain
2. Spinal Decompression Surgery
Performed when pain is caused by neural compression.
• Laminectomy / Decompression
Relieves pressure on spinal cord or nerve roots
• Tumor Debulking
Partial removal of plasmacytomas compressing nerves
Used for:
Radicular pain
Myelopathy
Progressive neurologic deficits
3. Spinal Stabilization / Instrumentation
Often combined with decompression.
Rods, screws, or cages to stabilize weakened bone
Reduces mechanical pain and prevents collapse
Used for:
Pathologic fractures
Spinal instability due to lytic lesions
4. Intrathecal Drug Delivery Systems (Pain Pumps)
A neurosurgically implanted pump delivering medication directly into cerebrospinal fluid.
Common agents:
Morphine
Hydromorphone
Ziconotide
Baclofen (if spasticity present)
Advantages:
Lower systemic side effects
Effective for severe, persistent cancer-related pain
5. Spinal Cord Stimulation (SCS)
Neuromodulation technique.
Electrical stimulation of dorsal columns
Alters pain signaling pathways
Used for:
Neuropathic pain
Post-treatment pain syndromes
Survivors with long-term pain after disease control
Less common in long-term survivors but still relevant.
• Chemical Neurolysis
Alcohol or phenol injections
• Radiofrequency Ablation
Destroys pain-transmitting nerve fibers
Used for:
Focal, severe pain
Patients not responding to other therapies
8. Sympathetic Nervous System Blocks
Neurosurgery or pain neurospecialists may perform:
Celiac plexus block
Stellate ganglion block
Used for:
Visceral or regional pain syndromes
9. Minimally Invasive Ablation Techniques
Often done collaboratively with interventional radiology.
Cryoablation
Radiofrequency tumor ablation
Used for:
Painful focal bone lesions
Patients not surgical candidates
Key Considerations for Myeloma Survivors
Bone fragility and infection risk must be carefully assessed
Many procedures require stable disease or remission
Multidisciplinary evaluation (neurosurgery, oncology, pain medicine) is essential
Have you been diagnosed with multiple myeloma? Are you struggling with any types of therapy-induced pain? Scroll down the page, post a question or comment, and I will reply to you ASAP.
Cancer pain is often undertreated. The standard approaches to pain management also often entail debilitating side effects or provide only transient relief. For select patients, Mayo Clinic offers neurosurgical options that can enhance quality of life.
“Surgery for cancer pain is heavily underutilized. We need to do a better job of getting these patients to a surgeon in a timely manner,” says Rushna P. Ali, M.D., a functional neurosurgeon at Mayo Clinic in Rochester, Minnesota.
Managing cancer pain historically has focused on high-dose opioids for people with short-term expected survival. But advances in oncologic care mean more people are living longer with cancer. Even patients considered disease-free can experience chronic pain, including postsurgical syndromes and chemotherapy-induced peripheral neuropathic pain.
“About 30% to 40% of these patients with life expectancy of five years or more continue to deal with severe cancer-related pain — though this is likely an underestimation,” Dr. Ali says. “That pain has a significant impact on quality of life.”
Neuromodulation can provide relief for patients with life expectancy of at least six months. Patients with shorter expected survival can benefit from lesioning procedures that short-circuit pain pathways.
“We don’t want patients in their last six months to be in miserable pain or in an opioid-induced haze and unable to spend quality time with their loved ones,” Dr. Ali says. “The latest statistics show that about half of cancer patients die in pain. We haven’t made a meaningful improvement in their quality of life in their last days.”
Centered on patient care
Cancer pain can be nociceptive or neuropathic, arising from nerve injury due to the underlying cancer or the effects of chemotherapy or radiation therapy. Medication is generally the first treatment choice. But side effects can limit patients’ ability to live functional, productive lives.
Local nerve blocks are another typical option. “Although the effects of those treatments can last weeks or sometimes months, the pain always comes back,” Dr. Ali says. “The blocks can be repeated, but their efficacy continues to decrease.”
At Mayo Clinic, patients seeking surgical options undergo multidisciplinary evaluations to determine the type and location of their pain. That information, combined with patients’ cancer prognoses, helps determine treatment.
“Our surgical approach is tailored to the patient,” Dr. Ali says. “For patients with a life expectancy of six months or more, we typically want surgery that is less invasive and will have a longer lasting benefit.”
Neuromodulation fits those criteria. Surgically implanted pumps can deliver intrathecal pain medication. Surgically implanted spinal cord stimulators can block pain signals from reaching the brain…
She notes that pain pumps deliver morphine or other medications directly to patients’ relevant pain receptors. “The patient gets a continuous infusion of medication that isn’t absorbed by the body,” Dr. Ali says. “It’s the same benefit as taking oral morphine but with a much smaller dose and without the sides effects that come with taking a pill or having an injection.”
A more aggressive surgical approach might be used for patients with lower life expectancy. “Lesioning procedures can be helpful,” Dr. Ali says. “We can address pain regardless of location, after doing a thorough review to see if a patient is a candidate for this type of surgery.”
Patients generally respond well to surgical treatment for cancer pain. “Typically, these patients start off with severe pain. With the appropriate intervention, that pain can be brought to milder levels,” Dr. Ali says…
Neurosurgical options for myeloma pain Neurosurgical options for myeloma pain Neurosurgical options for myeloma pain
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2 comments
Jim Boersma says
a couple of weeks ago
Gekko MM’ers; Wishing you all a most Happy New Year and we all pray that our MM continues to be controlled. I am currently on Revlimid 5 mg daily for 21 days then 7 days off. My MM remains in remission thank the LORD. I have battled joint and bone pain by taking Collagen and Gelatin daily in my AM coffee. It has really helped umprove my joint mobility, tendon and ligament structure. For many it could give some relief. God’s blessings to you all!!
