26th June 2023

An elderly gentleman presents with a 1-year history of progressive symptoms, including neck pain

An elderly gentleman presents with a 1-year history of progressive symptoms, including neck pain, tingling sensation of his hands bilaterally and shooting pains from his upper arm to his fingers. He is from a traveller community and has been moving around the country with no routine health check-ups.

An MRI whole spine reveals evidence of cervical spinal metastases with no signs of cord compression; further CT imaging suggests a likely lung primary cancer.

Following MDT discussion, surgery is deemed inappropriate, and the patient refuses any chemotherapy.

He is troubled by ongoing severe neck pain despite therapy from all steps of the WHO analgesic ladder. Which of the following would be the next option to consider for management of his pain?

Select the SINGLE correct option from the list below. Select ONE option only.