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Cancer pain procedures

Where cancer pain is not adequately controlled by medication, or where medication side effects are limiting, targeted procedures can reduce pain directly. These include nerve blocks, neurolytic techniques and intrathecal catheters, and they are used alongside — not instead of — your existing care.

In brief

  • For pain not controlled by medication, or where side effects are limiting.
  • Includes plexus and nerve blocks and neurolytic techniques.
  • Intrathecal catheters for selected patients.
  • Coordinated with oncology and palliative care teams.
  • Referrals in this group are prioritised.

Most cancer pain can be managed with medication. Where it cannot, or where the doses required cause sedation, nausea or confusion that costs someone the time they have, targeted procedures can reduce pain at its source and allow medication to be reduced.

Nerve and plexus blocks

Local anaesthetic placed around a nerve or nerve plexus supplying the painful region interrupts pain transmission. This is often used first as a diagnostic and predictive step — establishing how much pain is carried by that target before anything longer-lasting is done.

Neurolytic techniques

Where the situation warrants a longer-lasting result, the nerve can be interrupted more durably. Coeliac plexus and other visceral targets are well established for pain from abdominal malignancy, and can substantially reduce both pain and the medication burden. These are considered carefully, with the expected duration of benefit weighed against the clinical situation.

Intrathecal catheters

Delivering medication directly into the fluid around the spinal cord achieves effect at a small fraction of the systemic dose, which markedly reduces side effects. This is used in selected patients with severe pain not controlled by other means, and is set up in coordination with the treating and palliative care teams.

Timing

These options are often considered late, when they would have helped earlier. Referral at the point where pain is becoming difficult to control — rather than when all else has failed — allows better planning and a better result.

Working with your team

Dr Martin works alongside your oncologist, palliative care physician and general practitioner. Nothing is done in isolation, and the aim is to fit with the overall direction of your care and your own priorities.

Referral

Referrals for cancer pain are prioritised. GPs, oncologists and palliative care teams can contact the rooms directly to discuss timing.

Risks

Whilst pain procedures are generally safe and well tolerated, all procedures carry risks. The specific risks relevant to you and your procedure will be discussed with you, and written information provided, before you decide to proceed.

Practical information

Where
Most procedures are performed as a day case at St John of God Subiaco Hospital, Hollywood Private Hospital, Mount Private Hospital or St John of God Midland Hospital; some smaller procedures are performed in the rooms at Mount Lawley. The setting is confirmed with you at booking.
Referral
Required from a GP or specialist — by Healthlink (EDI painmdwa), fax 08 6114 0717 or email. Routine appointments are generally available within two to four weeks.
Before the day
Fasting, medication and transport requirements are set out on Before your procedure. If you take blood-thinning medication, or diabetes or weight-loss injections, tell the practice well before the day.
Costs
Dr Martin is a no-gap provider for in-hospital procedures with all major health funds, subject to your level of cover. A fee estimate is supplied on booking, prior to your consultation. See Fees and billing.
Afterwards
If your procedure is under sedation you cannot drive for 24 hours afterwards — please arrange transport home. Written post-procedure instructions are provided.
Rural and remote
Assessment and review can be done by telehealth; the procedure itself is scheduled in Perth.

How to arrange an appointment

A referral from a GP or specialist is required. Referrals are accepted by Healthlink (EDI: painmdwa), fax 08 6114 0717 or email admin@painmedicinewa.com.

Enquiries: 0448 299 260 — Monday 9:00am – 4:00pm, Tuesday to Thursday 8:00am – 4:00pm.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

This page provides general information only and is not a substitute for individual medical advice. Whether a treatment is appropriate for you is a decision made in consultation with your doctor.

In a medical emergency, call 000.