Cancer Pain Fellowships?

[Rocuronium18]

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I am a new-in-practice pain physician, having recently completed fellowship. I'm in an academic setting, but our center is looking for more experience with cancer pain management, and I didn't receive a ton of specific cancer pain management during fellowship. I'm wondering if you have any recommendations for specific cancer pain fellowships, or centers with really good exposure to cancer pain management? Thanks in advance!

 

[willabeast]

you might check this out. only thing is...cancer pain referrals for pain docs are pretty sparse. Anesthesiology Pain Management

 

[Extralong]

I am a new-in-practice pain physician, having recently completed fellowship. I'm in an academic setting, but our center is looking for more experience with cancer pain management, and I didn't receive a ton of specific cancer pain management during fellowship. I'm wondering if you have any recommendations for specific cancer pain fellowships, or centers with really good exposure to cancer pain management? Thanks in advance!

MD Anderson, I hear has plenty of malignant pain exposure. Also, you can consider getting to know your Onc colleagues, make some friends, and see if referrals come your way.
Generally I agree with willabeast, cancer pain referrals to pain docs are sparse.

 

[Orin]

Depends on the area of the country you are in, but start by looking at the cancer pain research consortium meetings that Lisa Stearns in Arizona puts on or the MSK cancer pain meeting Amit Gulati has in NYC.

The key thing is building relationships and comfort with the referral sources. Cancer pain is a different beast but it's not necessarily lucrative/lifestyle friendly.

 

[MalloryWeiss]

Memorial Sloan Kettering Cancer Center is the place to go for exactly this. Contact Amitabh Gulati MD — the guy is brilliant.

 

[BobBarker]

There are no referrals to be had. I office with an oncologist. She does not prescribe much opioids at all. I get maximum of 4 patients/year.

 

[hyperalgesia]

I think a lot of CA pain is handled as a specialty by Hospice and Palliative Care.

 

[gdub25]

☝ That

 

[cowboydoc]

I Second MD Anderson. A mentor did fellowship there and is part of surg onc dept. at university hospital.

My neighborhood oncologist is great. She has referred as many of her staff to me as she has patients, so not a lot of volume!

 

[TheLoneWolf]

Sloan Kettering

MD Anderson

Textbook we had in fellowship on cancer pain edited by former ASRA president Oscar Deleon who works in SUNY Buffalo

 

[painfree23]

What’s so special about cancer pain? Doing more risky procedure because less consequences? Wat type of procedure are you doing more of? I see some and the only thing for me is more liberal narcotic prescription ~ see a lot of lung, some with Mets to bone, brain, heent.

 

[Rocuronium18]

Thanks everyone for the feedback and insights. To provide some context on some of the points being raised, I am practicing in Canada - we are not so dependent on referrals from private practice, and our center is a tertiary care pain center. We are now being asked if we can incorporate cancer pain management to link with our cancer center. We do a small number of intrathecal pumps for palliative patients, but just wondering about further exposure to managing these and perhaps doing other neurolytic procedures.

 

[deleted993114]

I am a new-in-practice pain physician, having recently completed fellowship. I'm in an academic setting, but our center is looking for more experience with cancer pain management, and I didn't receive a ton of specific cancer pain management during fellowship. I'm wondering if you have any recommendations for specific cancer pain fellowships, or centers with really good exposure to cancer pain management? Thanks in advance!

Why? Oncology is notoriously poor in referring pain patients until it is too late.

I don't think I have ever encountered an oncology service that has been a good referral source, ever.

Having had advanced cancer X2 with significant pain issues associated with the cancer/treatment, it is interesting to see the process from a patient's view. You literally have to ask the oncologists for help and specify exactly what you need/want. I had to hand one of my oncologists a pain protocol for cystitis/bladder CA/partial cystectomy pain. I have had friends and family members who had to ask me to for suggestions for specific meds from pain/side effects of their cancer treatment which the oncologists were ignoring.

 

[Laryngospasm]

I think what people are that it’s a waste of time. Do self learning on your own time would be a better option if you are really interested.

 

[painfree23]

Why? Oncology is notoriously poor in referring pain patients until it is too late.

I don't think I have ever encountered an oncology service that has been a good referral source, ever.

Having had advanced cancer X2 with significant pain issues associated with the cancer/treatment, it is interesting to see the process from a patient's view. You literally have to ask the oncologists for help and specify exactly what you need/want. I had to hand one of my oncologists a pain protocol for cystitis/bladder CA/partial cystectomy pain. I have had friends and family members who had to ask me to for suggestions for specific meds from pain/side effects of their cancer treatment which the oncologists were ignoring.

Do you mind sharing this protocol! Would love to see it!

 

[r4uforever]

University of Utah Dept. of Pain Medicine. They have a huge volume of cancer pain at their Huntsman cancer center at salt lake city.

Pain Medicine | University of Utah

medicine.utah.edu

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[SommeRiver]

Saw a few in fellowship. Imminently dying. Put a TAP cath in one with remarkable improvement. Other than that I watched a few inpt Oncologists put ppl on PCA with high basal rates and on demand that was way too aggressive that required Narcan.

Outpt I wouldn't go looking for this.

 

[powermd]

In ten years at my old practice I never saw one referral from the local hospital-owned cancer institute. I would see some of their patients, but only because the primary doc sent them. And kypho? Forget about it- they all went to rad onc. Same hospital system, of course! There's a lot we could do for these patients if given the chance. I've always heard heme-oncs take total ownership of their patients.

 

[lobelsteve]

In ten years at my old practice I never saw one referral from the local hospital-owned cancer institute. I would see some of their patients, but only because the primary doc sent them. And kypho? Forget about it- they all went to rad onc. Same hospital system, of course! There's a lot we could do for these patients if given the chance. I've always heard heme-oncs take total ownership of their patients.

Not by me. I see about 1 per day.