A 50-year-old man with squamous cell lung cancer developed progressive right-sided pelvic pain in the region of known pelvic metastases. He describes dull-aching pain rated at 8/10 in the lateral pelvis and sharp shooting pain that radiates down the right leg. The pain limits mobility and awakens him from sleep. He has no focal motor or sensory deficits. An X-ray shows a large lytic metastasis in the lateral pelvis.
He was referred to a radiation oncologist who recommended a course of palliative XRT at 300 cGY per day for 10 days (total dose 3000 cGY). The patient has been taking MS-immediate release, 30 mg every 4 hours, which worked until the past week. He currently takes this dose every 4 hours but his pain only decreases from 8/10 to 6/10 for 1-2 hours at best. What can be an alternative treatment/therapy to reduce the pain in this patient? *This case is from Docplexus Editorial…
