“I am afraid not of cancer but of the pain” a phrase frequently heard by physicians working with cancer patients very well reflects the true burden. An estimated 1/3rd of patients with cancer and 2/3rd of patients with advanced cancer suffer from moderate to severe pain.

Cancer pain is usually multifactorial in origin affecting the physical, psychological, spiritual, and social functioning of the patients and their families. Cancer pains can be caused by compression of the nerves/ spinal cord, stretching of the liver capsule, post-surgery eg. Phantom limb pain, post-surgical chronic pain, post-mastectomy pain, bedsores, constipation, sciatica, back pain, etc.

WHO suggested a step ladder approach to the treatment of cancer pains. It involves the use of Non-opioid pain killers early on in the disease course followed by sequential use of weak and strong opioid drugs. Interventional pain management options include the use of nerve ablation procedures and nerve blocks like sympathetic plexus blocks, celiac plexus/ stellate ganglion blocks, radiofrequency nerve ablations for the management of intractable cancer-related pains.

Chronic pancreatitis/ Gall bladder Cancers/ Abdominal Cancer

The use of celiac plexus blocks, Sympathetic nerve blocks are excellent options for managing pain in these patients. These are daycare procedures that don’t require hospital admissions and the patients can return to their homes the same day. 

Chronic Pelvic Pain/ Vulvodynia/Endometriosis/Abdominal Pain

Causes of genital region pain in female patients can be effectively managed with targeted sympathetic nerve blocks helping in alleviating pain and improving social, psychological, and physical aspects in patients’ lives.