Surgery and other non-medication special procedures are useful tools in the arsenal of methods to treat some forms of cancer-related pain.  Surgery itself can be used to reduce the size of tumors, move tumor out of the path of obstructing the digestive system, alleviate pressure on nerves, drain fluids related to cancer growth (ascites). Sometimes surgery is also used to stabilize bones that have been treated by radiation or chemotherapy to reduce metastases.

     Special Procedures

     Special procedures is a catch-all term that includes a variety of pain-relieving methods. Some special procedures used to treat cancer pain include:

1.     Nerve blocks

     Nerve blocks involve the injection of anesthetic medication into specific areas of the body where pain is experienced, notably the nerves. Medications sometimes used for nerve blocks include lidocaine or bupivacaine, used alone or in combination with corticosteroids.  The effectiveness of nerve blocks is usually tested by doing what is called a "temporary block" first and if this brings relief, then a "permanent" nerve block may be performed.  Permanent blocks are not usually permanent, but may provide three to six months of pain relief.  There are other types of nerve blocks that can be used to relieve pain as well.

2.     Radiofrequency ablation

     While the patient is sedated, a radiologist uses a special needle to deliver radiofrequency current into a tumor, which then destroys cancer cells. This procedure has few side effects and can provide pain relief for some kinds of pain for several months. It can also be repeated when necessary.

3.     Non-Drug Approaches

     These are methods that can help supplement pain medications and other forms of pain relief, and are generally not intended to resolve pain all by themselves.

·         Heat: Heat can relax muscles and ease spasms, as well as encourage circulation in the body. Warm packs and heating pads can bring comforting relief.  Be sure not to apply heat to tumor sites or to areas that have recently been radiated. Apply heat for 10-20 minutes, then remove it for the same amount of time before applying again, if needed.

·         Cold: Cold, usually in the form of a cold pack wrapped in one or more layers of cloth to prevent direct contact with the skin, is excellent for reducing inflammation and can help ease nerve pain. Use cold packs carefully, keeping them applied to the body for no more than 10-20 minutes at a time, repeating as needed after rest periods of the same amount of time.

·         TENS: TENS stands for transcutaneous electrical nerve stimulation, and it is a low-voltage current that is transmitted to the body via electrodes placed on the skin. A portable battery is the power source. A tingling sensation is felt (and this is adjustable in intensity, for comfort) and for some people, pain is reduced where the TENS is applied. A health care professional can instruct you in placing the electrodes and using the equipment.

·         PENS: PENS stands for percutaneous electrical nerve stimulation, and involves the insertion of needles into the soft tissue around bones. A low-level current is passed into the body through the needles, and for some people this helps relieve the bone pain associated with cancer.

·         Positioning: Using orthotic devices can immobilize and support painful or weakened areas of the body.  Examples of orthotic devices include a splint on a painful limb or a collar for patients with neck or back pain. When cancer has weakened bones, positioning can, in some instances, provide relief.

     Also see the section on Alternative and Complementary methods of pain relief for other non-drug approaches to pain control.