Doctors At HCG Cancer Hospital, Vadodara Use A Compelling Technique To Offer Long Lasting Pain Relief To 59-Yr-Old With Pancreatic Cancer

HCG Cancer Hospital, Vadodara performed a novel procedure using an effective tool to relieve unendurable pain from Rekha (name changed), a 59-year-old woman suffering from pancreatic cancer that had spread to liver and bone. Computed Tomography (CT) guided Celiac plexus neurolysis is a neurolytic procedure to reduce abdominal pain among pancreatic cancer patients. This technique can potentially improve pain control in pancreatic cancer without increasing opioid consumption.

The 59-year-old with cancer in the pancreas that had spread to her liver and bone was suffering from severe upper-right quadrant abdominal pain for six long months. The pain couldn’t be managed even with strong opioids while she was on an adjuvant cancer treatment. She also suffered from frequent nausea and indigestion. She visited HCG Cancer Hospital Vadodara to seek relief from the unbearable pain.

In order to provide a long-lasting pain relief, the expert doctors at HCG Cancer Hospital, Vadodara decided to go for an alternative interventional therapy – celiac plexus neurolysis to destroy the plexus selectively and block the visceral afferent nociceptor (conscious visceral sensations like distention, cardiac ischemia and unconscious visceral sensations like blood pressure and chemical composition of the blood) transmission.

Dr Pranav Patel, Director and Consultant, Critical Care and Pulmonology, HCG Cancer Hospital, Vadodara, said: “Excruciating abdominal pain is an issue of major concern among those suffering from pancreatic cancer, especially in cases where cancer has metastasized to other organs from pancreas. Beginning from the stomach area, this pain can spread to the back and becomes worse after meals and when one lies down, significantly affecting day to day activities and quality of life. Managing cancer induced abdominal pain becomes a daunting task as it involves chronic use of high-dose narcotic analgesics that come with severe adverse side-effects. An outpatient procedure, this technique has successfully been able to offer pain relief and resolve the nausea and indigestion issue that our patient was suffering from without any side-effects. She tolerated the procedure very well with stable vitals. No incidence of hypotension, tachycardia, or any other complications have occurred.”

The procedure can take about an hour to finish where the patient has to lie prone on the stomach or could be on their back. An intravenous sedative is given to relax the patient. Imaging scans from fluoroscopy X-rays, CT scan or endoscopic ultrasound are used to guide the procedure. The treatment area is sterilised with an antiseptic and is numbed with a local anaesthesia. A needle is inserted into the back and the needle placement is confirmed by injecting a small amount of contrast dye that appears on the imaging scan.

After this needle is withdrawn, another needle is used to inject an alcoholic solution into the celiac plexus. In this case the solution consisted of 5cc 0.25% bupivacaine + 40 mg particulate methylprednisolone 25 mcg fentanyl + 10cc 70% alcohol. This injection damages the nerves and does not allow pain signals from traveling to the brain, thereby reducing pain. The success of the neurolysis depends on the spread of the solution in the celiac area. It is an effective way of palliative pain management. It can be used among those with cancer of pancreas, liver, spleen, kidneys, gastrointestinal tract.

It has an array of advantages. It is not only a safe and efficient way of pain management but also has a relatively low rate of complications due to the use of low volume of drugs with effective spread. CT guidance makes the procedure more accurate in terms of location and precise in terms of outcome with fewer side effects. Appropriate use of cross- sectional imaging knowledge, CT technique, and various adjunctive maneuvers are invaluable to ensure good results. With this procedure, pain relief can be obtained within 15 to 30 minutes following the procedure.

Mr. Varun Mishra, COO, HCG Cancer Centre, Vadodara, said: “We’re glad to be able to conduct Celiac Plexus Neurolysis, a game changer in managing pancreatic cancer induced pain, successfully. HCG Cancer Hospital has been a pioneer in conducting effective procedures to enhance quality of life of cancer patients and make cancer care in India exemplary. This is one such procedure in alignment with our objective and highlights the precision of our doctors. ”

Rekha, the patient, said: “I was suffering from intolerable abdominal pain and was praying for long-term relief. I am grateful to the doctors at HCG Cancer Hospital, Vadodara for giving me a painless life now. This procedure has made my quality of life better and I can now live peacefully.”

About HCG Cancer Centre, Vadodara
HCG Cancer Centre in Vadodara is the most advanced comprehensive cancer care centre in Central & South Gujarat. This Cancer Centre houses 73 beds, to provide high quality and comprehensive cancer care. The centre has the latest offering in cancer care for its patients’ benefits, along with a multi-disciplinary approach. The Cancer Centre comprises a team of specialists in medical oncology, surgical oncology, and radiation oncology. The diagnostics wing at HCG, Vadodara offers the latest technology in pathology, radiology, mammography, endoscopy and laparoscopy facilities.

This article was shared with Prittle Prattle News as a Press Release.

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