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Letter
Percutaneous cervical cordotomy for cancer-related pain: national data (response to letter by Professor S Mercadante)
  1. Marlise Poolman1,
  2. Matthew Makin2,
  3. Jess Briggs3,
  4. Kate Scofield4,
  5. Nick Campkin5,
  6. Michael Williams5,
  7. Manohar Lal Sharma6,
  8. Barry Laird7 and
  9. Catriona R Mayland8,9
  10. On behalf of the INPIC Group
    1. 1 Bangor Institute for Health & Medical Research, Bangor University, Bangor, Gwynedd, UK
    2. 2 North Manchester Care Organisation and Pennine Acute Hospitals NHS Trust, Manchester, UK
    3. 3 The Christie Hospital NHS Trust, Manchester, UK
    4. 4 St Columbas Hospice, Edinburgh, UK
    5. 5 Queen Alexander Hospital, Portsmouth Hospitals NHS Trust, Portsmouth, UK
    6. 6 Walton Centre for Neurology and Neurosurgery, Liverpool, UK
    7. 7 Institute of Genetics and Molecular Medicine, The University of Edinburgh, Edinburgh, UK
    8. 8 Department of Oncology and Metabolism, The University of Sheffield, Sheffield, UK
    9. 9 Palliative Care Institute, University of Liverpool, Liverpool, UK
    1. Correspondence to Dr Catriona R Mayland, Department of Oncology and Metabolism, The University of Sheffield, Sheffield S10 2SJ, UK; C.R.Mayland{at}sheffield.ac.uk

    https://doi.org/10.1136/bmjspcare-2020-002433

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      To the editor

      We thank Professor Mercadante for his interest in our work and welcome the opportunity to comment. The indication for cordotomy in the cohort reported was for cancer pain which had not been successfully treated with opioid and adjuvant analgesia. The indication was further supported by referral from experienced practitioners in palliative care and/or oncology and ratified by experienced specialists in pain medicine working in tertiary referral centres, as part of multidisciplinary teams including specialist palliative care.

      All but two of our patients were on strong opioid medication in significant dosage at the time of cordotomy. We accept that all patients may not have exhausted every analgesic entity (eg, trial of multiple …

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      Footnotes

      • BL and CRM are joint senior authors.

      • Twitter @CattyRM

      • Collaborators On behalf of the INPIC Group: John Ellershaw, Hugh Antrobus, Austin Leach, Heino Hugel, Jo Byers, Gary Jeffers, Paul Cook and Peter Walton.

      • Contributors BL drafted the initial letter and revised this with CRM. JB, NC and MLS reviewed and revised the draft letter. CRM, BL, MM, JB, KS, NC, MW and MLS all approved the final, submitted version.

      • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

      • Competing interests None declared.

      • Patient consent for publication Not required.

      • Provenance and peer review Not commissioned; internally peer reviewed.