Palliative Pain Management

What is palliative pain management?

Pain is a common problem for patients with cancer and other serious illness. Pain is sometimes caused by the disease itself, and sometimes is a side-effect of treatments such as chemotherapy.

Palliative pain management helps to relieve discomfort and improve quality of life. Unlike hospice care, palliative pain management is not limited to patients with terminal conditions. It can be helpful to patients of all ages and at any stages of a serious illness.

MedStar Georgetown University Hospitals offers a range of interdisciplinary palliative services. Interventional radiology is often a crucial component of this care.

How is palliative pain management performed?

Any procedure that is primarily focused on alleviating discomfort, not on prolonging life or treating underlying causes of pain, is considered to be palliative.  Radiological procedures can be used to alleviate pain in many ways. Examples include:

  • Ablating painful tumors: Many patients with cancer develop bone metastases, a type of secondary tumor caused by cancer cells moving into the bones. These metastases can weaken the bones and cause pain. Minimally invasive procedures such as radiofrequency ablation, microwave ablation, or cryoablation can be used to remove painful bone metastases.
  • Relieving fluid retention: Some types of cancer cause the body to retain fluid. This excess fluid can cause pain, make movement difficult, and suppress appetite. Radiological procedures can be used to guide the placement of drainage tubes (catheters or shunts), relieving pressure and discomfort.
  • Alleviating nerve pain: Pain is caused by activity in the nerves. Through a procedure called neurolysis (“nerve block”), heating or freezing agents can be applied to nerves. This interrupts pain signals.
  • Treating spinal fracture pain: A procedure called kyphoplasty can be used to stop pain caused by a spinal fracture. This procedure allows the interventional radiologist to reposition the vertebrae and stabilize the bones using a special paste.

What should I expect before, during, and after treatment?

Before any palliative pain treatment, your doctor will talk with you about how to prepare for your procedure. Some interventional radiological procedures require fasting or medication changes in advance of the procedure. Your care team will give you individualized instructions.

What are the risks and benefits of palliative pain management?

Palliative pain management is intended to improve quality of life and make you feel more comfortable.  Many patients find that palliative pain relief increases their enjoyment of life and reduces stress for them and their families.

Potential side effects vary by procedure, but these interventions are generally minimally-invasive and low-risk. You and your care team will discuss the potential risks and benefits of any palliative measure.

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