How to use implantable intrathecal drug delivery systems for refractory cancer pain.

Dr. Smith is Professorand Chair of theDivision of Hematology/Oncology and PalliativeCare at the VirginiaCommonwealth UniversityHealth System, Richmond,Virginia.Mr. Coyne is Director ofClinical Services on theThomas Palliative CareUnit of the VirginiaCommonwealth UniversityHealth System, Richmond,Virginia.Correspondence to: Thomas J. Smith, MD, Division ofHematology/Oncology, Virginia CommonwealthUniversity, MCV Box 980230, Richmond, VA 23298-0230;telephone: (804) 828-9723; fax: (804) 828-8079;e-mail: tsmith@hsc.vcu.edu