Targeted pain treatment for pain in chest and back of chest

Thoracic sympathetic pain intervention

The thoracic sympathetic interventional procedure involves using a mixture of strong medications or RF ablation onto the upper back sympathetic pain nerves. This treatment is used to relieve pain associated with the lung cancer and some other cancers.

What are the thoracic sympathetic nerves?

The sympathetic nervous system arises in the middle of the back (thoracic) and lower back (lumbar) spine regions. These nerves run in a parallel manner along and adjacent to spine towards the brain. The thoracic sympathetic nerves carry the pain message to brain from lungs and some other body parts.

What can I expect before the sympathetic interventional procedure?

The specialist doctor will first discuss the benefits and risks of this procedure and ask you to sign a form of informed consent. When you arrive at our medical centre, an intravenous drip will be started. Some devices are attached to your body to monitor oxygen level, heart rate, and blood pressure. Be sure to notify the doctor a week beforehand regarding all medications you are taking, as certain ones may be held for several days. In most cases patients remain awake throughout the treatment.

How is the thoracic sympathetic interventional procedure done?

You will be made to lie on your belly using pillows for support. The skin is cleaned with an antiseptic solution, and a numbing medicine is used to numb the upper back skin and deeper tissues. Using x-ray imaging / fluoroscopy, the needle like instruments (known as cannula or probe) are guided near the sympathetic nerves, and a medicated contrast solution is used to confirm the placement. Once the medications are given onto the nerves or RF ablation is done, the doctor removes the probe and places a dry bandage over the area.

What can I expect after the thoracic sympathetic procedure?

After the procedure, you will be observed for sometime. Expect a numb sensation running down the back and chest and a little discomfort at the procedure site. These effects are temporary and will resolve in a few hours. We recommend you rest for 1-2 days and gradually return to usual activities.

What risks and complications could occur?

As with any minimally invasive procedure, a few rare risks are associated with the thoracic sympathetic intervention. These include allergic reaction to medication or contrast material, infection, bleeding, and low blood pressure.

Who should not have a thoracic sympathetic procedure?

The sympathetic pain procedure cannot be performed if the patient:

• Has an active infection
• Has uncontrolled blood sugar levels or heart condition
• Is taking blood-thinning medications
• Has an allergy to numbing medicine
• Less than normal platelets count. It can happen after chemotherapy or radiation.
• Has a bleeding disorder
• Has high fever

What conditions are treated with the Thoracic sympathetic pain procedure?

The Thoracic sympathetic pain procedure is very helpful in the following cancers:

• Pain relief in breast cancer
• Pain relief in food pipe (esophagus) cancer
• Metastatic cancer

Click on targeted Pain relief in bone metastasis to know how to treat back pain in advanced or stage 4 lung cancer, when cancer spreads onto bone and spine.

What is a neurolytic thoracic sympathetic plexus intervention?

For the neurolytic thoracic sympathetic  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 treatment 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 thoracic sympathetic plexus is generally advised for patients experiencing one of the below listed medical conditions:

• Lung Cancer
• Breast Cancer

In addition, to be a right candidate for radiofrequency ablation of thoracic sympathetic plexus, you must have responded well to the local anaesthetic 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, it’s 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.

Click on lung cancer to know about the signs and symptoms of lung cancer and how lung cancer spreads?

Click on palliative care treatment to know in detail about various problems faced by the patients with advanced cancer, their solutions and how to live with advanced cancer?

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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.