Hollings offers cancer patients relief with variety of pain procedures

June 22, 2022
illustration of a transparent human body with skeleton hunched over with one hand on its back and red pain emanating from its back
Back pain is a common complaint for cancer patients. Adobe Stock image by Julien Tromeur

One of the top concerns cancer patients have is how much pain they’ll be in before, during and after treatment. MUSC Hollings Cancer Center is here to help with cancer pain management and offers a variety of ways to better manage pain and improve the quality of life for patients.

Specialists at Hollings can manage cancer pain medications to provide relief and reduce dependence on opioids. Medications can also be prescribed to patients who are no longer in pain but who are physically dependent on opioids. In addition, pain specialists can connect patients to the MUSC Department of Psychiatry and Behavioral Sciences for assistance with coping with cancer stress and pain. Hollings also offers minimally invasive procedures that are tailored to meet the specific needs of the patient.

Thor Johnson, M.D., Ph.D., views pain management as an integral part of cancer care. HIs goal is to make it as easy as possible for cancer patients to connect with the proper care for their pain. 

“It’s not enough to survive cancer. You have to be able to provide patients a life that gives them dignity, independence and joy," he said. 

a man in a surgical scrubs works with a man in a lead apron in an operating room 
Dr. Thor Johnson, right, performs a kyphoplasty, a minimally invasive procedure to treat pain in the spine. Photo by Clif Rhodes

Cancer pain management procedures offered at Hollings include:

Intrathecal pain pump placement

This small pump is placed under the skin and allows doctors to deliver pain medication directly to the pain center in the spine. This option provides patients better control of their pain with fewer side effects than standard opioid therapy. The pumps can hold up to three months of medicine. This minimally invasive procedure does require an overnight stay in the hospital, but overall recovery time is usually between seven and 10 days. The pump can be set to deliver medicine at different times of the day or use a small cellphone-like device to allow patients to give themselves extra doses of pain medication safely as needed.

Kyphoplasty, bone ablation and cementoplasty services

Hollings offers pain relief for patients with tumors that have metastasized or affected their bones. Radiation therapy is oftentimes very effective for treating pain, but there are further options for patients whose pain persists after treatment. Specialists at Hollings offer a full range of bone tumor ablations that can kill a tumor by either freezing or heating it. Hollings also offers options to fix broken bones by using a very light, but strong, bone cement to fill and stabilize fractures. This minimally invasive procedure allows most patients to go home the same day with nothing more than a Band-Aid.

Nerve blocks and ablations

Nerve pain allows the body to communicate with the brain, if someone has been injured, by sending pain signals. However, in a cancer setting, tumors can overtake nerve function and signaling, causing the patient to be in significant pain. Blocking or killing the nerve can prevent pain transmissions and provide comfort to the patient. The most common nerve blocks performed in cancer patients include:

  • Celiac plexus block – This nerve cluster is located in the upper abdomen and can cause nausea and pain sensation from inside your skin. The cluster controls pain from the spleen, liver, pancreas, kidneys and the beginning of the small bowel. Hollings specialists usually ablate this nerve cluster using alcohol or freezing the nerve, which provides durable pain relief. The biggest side effect caused by this procedure is diarrhea.

  • Superior hypogastric plexus block – This block is especially effective in treating pain stemming from the pelvic area. The nerve cluster is located at the bottom of the spine and can be affected by cancers of the prostate, uterus, rectum, vagina and bladder.

  • Pudendal nerve block – This nerve feels pain in the bottom of the pelvis and the external region of the male and female organs. The nerve can be damaged during low-pelvic surgeries and in some gynecologic surgeries and due to cancers of the external male and female genitalia. The nerve will grow back in six to nine months, so sensation in the area will return.

  • Intercostal nerve block/ablation – Surgery of the chest or cancer that invades the nerves of the chest wall can cause severe pain, which is generally worsened by breathing. A nerve block or ablation can reduce pain. The nerves will grow back in six to nine months, at which time the procedure can be repeated as necessary.

  • Scrambler therapy – Scrambler therapy is an FDA-approved treatment for chronic neuropathic pain that some cancer patients may experience. The therapy involves the use of a device to send electrical impulses to provide “non-pain” information to nerve fibers that had previously been receiving pain messages. By providing the new messaging, the body will stop sending pain signals to the brain and relieve a patient’s pain level. Scrambler therapy is given daily for 10 to 12 days and lasts between 30 and 45 minutes.

Patients who wish to schedule an appointment with a pain specialist should call 843-792-9300.