Psychological evaluation is recommended before and after IDD pump implantation in cancer patients. Cancer prognosis, loss of independence, and treatment-related morbidity can significantly impact psychological well-being. Although psychological distress often correlates with poorly managed pain or medication side effects, it should not be a barrier to IDD use. Psychological assessments should guide treatment planning without causing delays in pain management^23,24,25,26.

Consensus Point 2. The PACC recommends that in cancer pain, psychological assessment and treatment continue to be important to evaluate and counsel the patient on issues such as cancer prognosis, death and dying, and anxiety or depression but should not unreasonably delay IDD. USPSTF Grade B; Level of certainty low; Quality of evidence II.