What is this procedure?

Neurolysis is a procedure that ablates the nerves or nerve plexuses
carrying pain signals from a cancer-affected organ, using a chemical agent
such as concentrated alcohol or phenol, or heat from radiofrequency energy —
interrupting pain transmission for a prolonged period.

Neurolysis is one component of comprehensive cancer pain care,
working alongside medication optimization and palliative care.
The goals are less pain, lower medication doses, fewer drug side effects,
and better quality of life.

Common procedures in this group

Who is it for?

• Cancer patients with severe, localized pain that is poorly
  controlled with pain medication
• People with significant opioid side effects — drowsiness, nausea,
  severe constipation — that impair quality of life
• Patients with pancreatic or upper abdominal cancer, for whom the
  procedure can be considered early in the course of pain, without waiting
  for medications to fail first

What happens during the procedure

1. The physician assesses your pain, reviews your imaging, and plans
   the procedure together with you, your family, and your treating oncologist.
2. In many cases a diagnostic local-anesthetic block is performed first
   to confirm the procedure will actually relieve your pain.
3. On the day of the procedure, you are positioned on the X-ray table
   and given light intravenous sedation for comfort.
4. The physician guides the needle to the target plexus under X-ray,
   confirms the position with contrast dye, and injects the neurolytic agent.
5. You are observed afterwards; some patients stay one night in
   hospital at the physician’s discretion.

What results to expect

• Pain usually improves clearly within a few days, and relief lasts
  for months — covering an important period of time for many patients.
• Most patients can reduce their pain medication doses,
  with correspondingly fewer side effects.
• The procedure does not replace cancer treatment itself, but it
  helps patients live better during treatment.

Risks you should know

Side effects depend on the site treated. After celiac plexus
neurolysis, for example, temporary low blood pressure or loose stools may
occur for 1–2 days and usually resolve on their own. Serious complications
are rare when the procedure is performed by a specialist under image
guidance. Your physician will explain the specific risks in detail and
decide together with you and your family, every time.