Priority 26 from the Mesothelioma PSP

UNCERTAINTY: Should interventions (e.g. cordotomy or radiotherapy) be used to control severe pain after surgical interventions for mesothelioma such as biopsy, VATS, pleurodesis, etc? (JLA PSP Priority 26)
Overall ranking 26
JLA question ID 0025/26 
Explanatory note Not available for this PSP
Evidence Systematic review - France BD, Lewis RA, Sharma ML, Poolman M. Cordotomy in mesothelioma-related pain: a systematic review. BMJ Support Palliat Care. 2014 Mar;4(1):19-29. doi: 10.1136/bmjspcare-2013-000508. Epub 2013 Sep 18.
Health Research Classification System category Cancer
Extra information provided by this PSP
Original uncertainty examples Cordotomy and interventional pain techniques ~ Poor pain control after VATS lead to immobility & thence to sacral sore which took some time to heal ~ he had an operation on his lungs to put some kind of 'chalk' in the outer part.  This resulted in extreme pain afterwards for a short while ~ Best way to obtain pain relief during biopsies in medical thoracoscopy ~ More pain after Video Assisted Thoracoscopy (VATS) than after Extra Pleural Pneumonectomy (EPP) ~ The medication never controlled the pain so that last year of life was miserable and awful for the patient and family ~ the radiotherapy was most helpful with pain relief
Comparison None identified
Submitted by Health professional x2 ~ Carer x2 ~ Bereaved x2 ~ Patient
Outcomes to be measured Pain relief
PSP information
PSP unique ID 0025
PSP name Mesothelioma
Total number of uncertainties identified by this PSP. 53  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 16 December 2014