Targeted pain treatment
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Treatment for arms pain in Breast cancer
What is a Stellate Ganglion treatment?
Pain due to breast cancer needs quick treatment. Few Interventions are needed to treat pain. Stellate ganglion treatment is one of them. This treatment is either neurolysis or RF ablation of stellate ganglion. Stellate ganglion is group of pain nerves that are a part of the sympathetic nervous system. These nerves can be found in the neck, on both side of the voice box.
What Is the Purpose of this Type of treatment?
This treatment will numb the pain nerves that go to the arms and to some degree, the pain nerves that go to the face. This might in turn reduce swelling, pain and sweating changes in the arms and might improve mobility.
This treatment is often done as a part of the treatment for breast cancer related pain after surgery, radiation treatment or chemotherapy involving the face, arm and the head.
Will the treatment Hurt?
This treatment involves insertion of a needle like instrument, called probe through skin and deeper tissues. So, yes, there is minimal pain being involved. But, the deeper tissues or skin may be numbed with a local numbing medication using a very thin needle before inserting the probe for the treatment. Most of those individuals will also receive anxiety relieving medications which can help the entire process be more tolerable.
How a Stellate Ganglion treatment done?
During the process of the treatment, pain-relieving medication is deposited to the region where the ganglion lies. Or ablation of ganglion is done with the help of RF ablation. This might reduce the release of the pain chemicals responsible for activating the pain sensitive nerves or make the pain nerves free from compression of cancer or tumour. This treatment is done, using the guidance of an X-ray or fluoroscopy, a very fine probe is placed near the ganglion and mixture of strong medication is given.
The patient will not feel numbness in the face. A pain diary is used following the procedure to track the response.
Will the Patient Be “Put out” for this treatment?
Patients remain awake during the whole treatment. Before starting the treatment a numbing medication is injected to make the skin and deeper tissue numb. So that patients don’t feel much and remain comfortable throughout the treatment.
How is the procedure performed?
It is done with patient lying comfortably on the procedure table with x ray machine / fluoroscope. The patients are supervised with blood pressure cuff, ECG, and device that monitor the oxygen level the patient is receiving. Probes sensing the temperature are also placed on your hands. The skin in the front of the neck, close to the voice box is cleaned with antiseptic solution and then the probe is placed.
What Should I do after Getting the treatment?
Unless there are complications, you should be able to return to work the next day. You might feel some soreness in the neck at the treatment site. The effect of numbing medicine wears off several hours. But the actual effect on pain nerves might last for many months. Usually, the duration of relief gets longer after each session, as this treatment might be repeated in some patients.
What is a neurolytic stellate ganglion intervention?
For the neurolytic celiac plexus intervention, we will use a concentrated medicated neurolytic medicine mixed with some numbing medicine. In contrast to the numbing medicine this neurolytic medicine will actually destroy the pain nerves. These selectively damaged pain nerves will not be able to let you feel the pain for a much longer time. It is very important to understand here that, this procedure does not affect the other normal roles of nerves or other nerves.
What is a Radiofrequency Ablation of Nerve?
Radiofrequency ablation of nerve or radio frequency lesion is a procedure using a specialized machine to interrupt the pain signals on a semi-permanent basis.
The basic principle of radio-frequency lesioining is placement of an insulated electrode probe into the target tissue or pain nerves and release RF waves.
When is the radiofrequency ablation of nerve used?
Radiofrequency ablation of nerve is generally used for patients with who all forms of commonly used pain medications are not giving satisfactorily pain relief. That means common methods of pain relief have failed..
Radiofrequency ablation of stellate ganglion is generally advised for patients experiencing one of the below listed medical conditions:
Arm pain or facial pain after breast cancer.
In addition, to be a right candidate for radiofrequency ablation of stellate ganglion, you must have responded well to the local anesthetic test block. ie before doing an RFA procedure, numbing medicine is given in the target pain nerves and if you get more than 50% pain relief immediately, its an indication to proceed for the radiofrequency ablation procedure. These two steps may be done on the same day or on different days, depending upon the patient’s condition and requirement.
What is the procedure?
The radiofrequency nerve ablation uses radio waves to produce heat directed at a specific pain nerve. The heat destroys the nerve and thus relieves pain. These damaged pain nerves will not be able to let you feel the pain for a much longer time. This procedure does not affect the other normal roles of nerves.
In this procedur, one probe is inserted. Ultrasound (USG) or fluoroscopic (X-ray) guidance is used to correctly position each instrument, known as cannula or probe. Once done, the radiofrequency ‘radio waves’ are directed through each cannula.
What are the benefits of Radiofrequency Ablation of Stellate ganglion?
The radiofrequency ablation of stellate ganglion has a series of benefits as compared to the other forms of pain relief. Here we list the main benefits:
- The target nerves can be accurately controlled, thus allowing lesioning of small nerves without damaging nearby other nerves.
- Pain relief is rapid and usually side effects are negligible, allowing the patient to return to normal activity very soon or may be same day.
- Nerve destruction is usually long lasting and heals without any complication..
- The rate of side effects and complications is relatively low.
- When pain recurs, nerve lesion can be repeated as necessary.
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In advanced stage of cancer, if cancer spreads to multiple places and patient has many pain spots; or if the above mentioned treatment fails to control the pain in few patients; Pain implant is used to treat the pain.
Note:-This information should not be used as a substitute for necessary consultations with an Oncologist or Cancer Pain Specialist or Palliative Care Specialist to meet your individual needs. Always consult a medically trained & qualified professional with questions and concerns you have regarding your cancer and cancer related problems.