Neuropathy pain caused by Taxol?
Meet the Experts
Neal Slatkin, M.D. is director of supportive care services and associate professor in the department of neurology at the City of Hope Cancer Center in Duarte, California.
Michelle Rhiner, N.P. is patient coordinator and department manager in the department of supportive care and palliative medicine at the City of Hope Cancer Center.
Jennifer Griggs, M.D., M.P.H. is a medical oncologist specializing in the treatment of breast cancer, with a a special interest in cancer survivorship, patient-physician communication, and quality of care for women with breast cancer.
Question from Marieanne: Please address treatment of pain associated with neuropathy caused by Taxol.
- Answer —Neal Slatkin, M.D.: I've long thought that physicians have a special responsibility to relieve the pain that they cause with their treatments, even though those treatments may be given fully appropriately and for the best of reasons. I think it's important for oncologists to be familiar with the various nerve pain medications.
There are several classes of medications that can be used to relieve nerve pain. Probably the oldest class is the tricyclic antidepressants. When the right agent is chosen and the medications are skillfully used, they often produce excellent pain relief.
Certain other classes of medications can also be useful, the most common being certain anticonvulsant or anti-seizure medications. The medication most commonly used in that category is Neurontin, which can be very safe and very effective.
Sometimes other classes of medication can also be useful. We often will use the drug Baclofen, which was initially approved to treat spasticity, but in certain nerve pain syndromes can be highly effective. Some individuals with Taxol-induced pain benefit as well, even from the anti-inflammatory medications, although those are not typically felt to be useful for nerve pain.
The next category of medications is the opiates. There are now several published trials in varying pain states indicating that the opiates can be quite useful in treating nerve pain. There are many other drugs as well, and the list I've provided above is by no means exhaustive.
On Wednesday, January 21, 2004, our Ask-the-Expert Online Conference was called Pain Management: Getting the Relief YOU Need. Neal Slatkin, M.D., Michelle Rhiner, N.P. and moderator Jennifer Griggs, M.D., M.P.H. answered your questions about the best ways to deal with the physical pain and discomforts associated with breast cancer and breast cancer treatment.
The materials presented in these conferences do not necessarily reflect the views of breastcancer.org. A qualified healthcare professional should be consulted before using any therapeutic product or regimen discussed. All readers should verify all information and data before employing any therapies described here.
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