Pain management specialist: MD Anderson lets me help cancer patients live their best lives

I got into medical school thinking I’d specialize in either cardiology or orthopedic surgery. But one of the great things about it is that you get to see and do so many different things before you finally finish. That’s how I discovered I liked being in the operating room, but didn’t necessarily want to be a surgeon.

I do enjoy physiology and pharmacology, though. So, anesthesiology seemed like a good fit. The only problem was that my interactions with patients tended to be very brief. Often, I’d be meeting them for the first time on the day of their surgeries. So, I had to develop a rapport with them very quickly, all while explaining what we were going to be doing during the procedures. I didn’t get to see how anyone did afterwards. And I missed that relational aspect of it, of feeling like I was actually somebody’s doctor.

That’s how I ended up in the sub-specialty of pain management. It gave me the long-term continuity I’d been craving. Now, I get to see how patients improve over time with treatment, while still working with my hands and learning new procedures. It’s perfect.

Treating the whole patient — not just their symptoms

At MD Anderson, I get to see the whole spectrum of patients. Some are dealing with pain that’s directly related to their cancer diagnoses. Others are experiencing it as a side effect of their treatments. And still others have pain that’s completely unrelated to their cancer — such as lower back pain — whether it started before or after their diagnosis.

We have several methods available for treating patients’ pain. First, there are medications. Second, there are interventions, such as surgery or other procedures. And third, there are alternative therapies, such as acupuncture, massage, physical therapy, and so on.

All of these play an important role in pain management, because at MD Anderson, we strive to treat the whole patient, not just the symptom itself. That’s one of the major benefits of coming here.

What’s new and exciting in pain management

Some of the most exciting developments in the field of pain relief right now deal with the application of medications directly to the spine. Potentially, this allows us to use lower doses — which, in turn, can decrease the incidence of side effects.

Another advance is in the area of neuromodulation, which involves the stimulation of the spinal cord or peripheral nerves with electricity. We do this by using either temporary devices or permanent implants. Both modulate the signals being sent to the brain with electrodes, which influences whether or not they’re interpreted as being painful.

Neuromodulation is still a rapidly developing field. But we’re already seeing some patients experience considerable relief when temporary devices are removed after being left in place for only 30-60 days. Some patients feel so good and report such drastic changes after just the trial procedure (the testing phase before the device is actually implanted), that they’re able to do things they haven’t done in years.

Not every patient is a slam dunk like that, but when you do have one, it’s still a big deal. It’s fantastic to know that your work is having such a positive impact on people’s lives.

Alleviating suffering: what drives us to keep improving

I feel really blessed to be at MD Anderson. Because here, both patients and physicians have access to anything we could possibly want, all under one roof. Not only can I refer someone to Integrative Medicine for mind-body issues, I can also refer them to cardiology for heart issues, or endocrinology for thyroid issues. And we have an entire cadre of other specialists on staff, should their services be needed.

Even at our Houston area locations outside the Texas Medical Center, we can often get patients in to see collaborating groups of specialists right away. And that’s a major advantage — both for us and for all of our patients.

No matter where I see them, though, relationships remain my favorite part of working at MD Anderson. I really enjoy getting to know people and watching their quality of life improve over time.

Obviously, our patients are the people most affected by a cancer diagnosis. But their families feel the burden of it, too. So, when you alleviate pain and suffering for one person, you really do it for the entire family. And knowing that is what continues to drive us all — to learn more and to do even better.

Uzondu Osuagwu, M.D., is a pain management specialist and anesthesiologist at MD Anderson.

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