Dr. Pietras Discusses Pain Management in Ovarian Cancer

Christopher J. Pietras, MD, director, Palliative Care, assistant clinical professor, University of California, Los Angeles (UCLA) School of Medicine, discusses pain management in patients with ovarian cancer.

Pietras says that the treatment of pain needs to be matched to both the disease and the goals of the patient. There is no single medication that will work for all patients, but a physician can determine whether it is something as simple as sleeping wrong that is causing the pain, or something more severe such as the tumor causing pressure on a nerve.

First-line medications that are often used to manage pain in patients with ovarian cancer are opioids, or gabapentin and tricyclic antidepressants such as nortriptyline or amitriptyline. If these medications are ineffective at high doses, Pietras says that ketamine is also a consideration. Ketamine can improve pain scores significantly, but larger studies and prospective trials need to be done to confirm these claims. It has not been concluded whether ketamine will result in symptom improvement.