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Frequently Asked Questions – Getting a Drug Pump

• How will my doctor know if I am a candidate for a drug pump?
• Why do I need to take a screening test?
• How long does the screening test take? Do I have to stay in the hospital?
• Will it hurt?
• Can I have other pain medication during the screening test?
• Will I receive the same relief that I get during the screening test when I receive my permanent drug pump?
• How long after the screening test is the drug pump implanted?
• What type of anaesthesia is used during implant?
• What is the average length of the hospital stay?
• On average, how long does the surgery take?
• How big are the incisions?
• Can a previous abdominal incision be used?
• Between which vertebrae is the catheter placed?
• How long will it take before I start receiving benefit from my pump?
• How often will the pump need to be refilled?
• Will people be able to see that I have a pump?
• What if my pain changes? Can my doctor increase or decrease my dosage?
• What if it doesn't work – can the pump be removed?

How will my doctor know if I am a candidate for a drug pump?

Your doctor can do a screening test to help predict whether a drug pump will provide cancer pain relief.

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Why do I need to take a screening test?

A screening test is a way for you and your doctor to evaluate your response to medication delivered into your spinal region to see if you are a candidate for a drug pump. If the pain caused by your cancer is measurably reduced, it means that the drug pump may work effectively for you.

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How long does the screening test take? Do I have to stay in the hospital?

This will vary depending upon the type of screening test your doctor feels would be best for you. The tests could take as little as a half day or as long as 4 days. Depending upon the type of screening test, you may undergo a procedure that takes approximately 1 to 2 hours and then need to stay in the hospital to be monitored after the procedure. Consult your doctor to understand the details for the type of screening test that your doctor thinks would be best for you.

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Will it hurt?

Before you are given the trial injection or the catheter is placed, your doctor may numb a small region of your lower back with a local anaesthetic.

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Can I have other pain medication during the screening test?

This will depend on your doctor and the severity of your cancer pain.

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Will I receive the same relief that I get during the screening test when I receive my permanent drug pump?

If the screening test has been successful and you go on to receive the implanted system, your pain relief may differ. Be sure to tell your doctor about the way you feel so that changes can be made that will give you the best pain relief possible.

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How long after the screening test is the drug pump implanted?

If the screening test is successful, you and your doctor will discuss when the system should be implanted.

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What type of anaesthesia is used during implant?

Typically, the implant is performed under general anaesthesia. However, you may wish to talk with your doctor about other options.

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What is the average length of the hospital stay?

The length of your hospital stay will be determined by your doctor.

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On average, how long does the surgery take?

Times vary depending on individual doctor technique. On average, the procedure takes approximately 1 to 3 hours from start to finish. Talk with your doctor about the specifics and duration of your procedure.

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How big are the incisions?

There are two incisions. One is for the pump and is located in your abdomen. The size of the incision depends on the size of the device and could be up to 15 centimetres long. The other incision, made on your back, is 5 to 10 centimetres long.

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Can a previous abdominal incision be used?

No, because the incision needs to be made where the pump will be implanted to help properly anchor the device.

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Between which vertebrae is the catheter placed?

This depends on your specific condition and the results you received from the screening test. Your doctor will advise you of the recommended location.

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How long will it take before I start receiving benefit from my pump?

You will begin receiving pain treatment as soon as your pump is filled with medication and the medication is delivered through the catheter to the specific site. However, depending on your medication, it may take several days before you experience benefits from your medication. You should discuss the use of your usual medication during this period with your doctor.

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How often will the pump need to be refilled?

The medication in your pump needs to typically be refilled every 6 to 12 weeks, depending on your dosage. It is refilled by a needle injection in your doctor's office. During these appointments your doctor can adjust your dose of medication to address your pain relief needs.

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Will people be able to see that I have a pump?

Because your pump is placed near the surface of your skin for easy refill access, on occasion someone might notice a slight bump if you are wearing fitted clothes. However, depending on your size and shape, where the pump is implanted, and the size of your pump, it may not show under your clothes at all.

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What if my pain changes? Can my doctor increase or decrease my dosage?

Yes. If your pump is programmable, your doctor can reprogram your dose. If your pump is not programmable, your doctor can change the concentration of drug in your pump, which then changes your dose.

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What if it doesn't work – can the pump be removed?

Yes. The screening test is designed to determine whether the pump will help manage your pain. However, if you no longer need the pump or change your mind about the treatment, your doctor can turn off or remove the system.

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Next: Living With a Drug Pump