The development of a lidocaine 5% patch (Lidoderm®; Endo Laboratories; Chadds Ford, PA) has facilitated the topical application of local anesthetics. This formulation is approved in the U.S. for the treatment of postherpetic neuralgia; however, there are a variety of case reports and small studies of its use in cancer syndromes. Clinical experience supports its use for other neuropathic pain conditions. There are a number of phase II studies that include patients with neuropathic pain related to either cancer or cancer therapy
Considering that the Lidoderm patch is fairly new and the kind an amount of evidence available and that there appear to be two phase II studies, I consider Lidoderm to be supported for local cancer pain syndromes. In addition, NCCN in its Adult Pain recommendation lists Lidoderm as an adjuvant treatment.
The Official Disability Guidelines state that Lidoderm patches are “not recommended until after a trial of a first-line therapy, according to the criteria below. …. Further research is needed to recommend this treatment for chronic neuropathic pain disorders other than post-herpetic neuralgia.
I.Wilhelm, N.Griessinger, W.Koppert, R.Sittl, R.Likar High Doses of Topically Applied Lidocaine in a Cancer Patient Journal of Pain and Symptom Management, Volume 30, Issue 3, Pages 203-204, 2008
Fleming JA, O’Connor BD. Use of lidocaine patches for neuropathic pain in a comprehensive cancer centre. Pain Res Manag. 2009 Sep-Oct;14(5):381-8.
Lema MJ, Foley KM, Hausheer FH. Types and epidemiology of cancer-related neuropathic pain: the intersection of cancer pain and neuropathic pain. Oncologist. 2010;15 Suppl 2:3-8.
Devers A and Galer BS. (2000) Topical lidocaine patch relieves a variety of neuropathic pain conditions: an open-label study. Clin J Pain 16:205–8, 2008
Meier T, Wasner G, Faust M, et al.: Efficacy of lidocaine patch 5% in the treatment of focal peripheral neuropathic pain syndromes: a randomized, double-blind, placebo-controlled study. Pain 106 (1-2): 151-8, 2003.
NCCN, Adult Pain, 2012