5.1 Introduction
Invasive nonpharmacologic interventions complement behavioral, physical, and
drug therapies in a substantial minority of patients in whom these therapies
alone do not control pain (see Figure 3). With rare exception, noninvasive
analgesic approaches should precede invasive palliative approaches. Although radiotherapy
and surgery can cure primary disease, they are discussed here in relation to
pain relief only. Surgical procedures are useful in selected patients to debunk
tumors and hence reduce symptoms of obstruction or compression. Anesthetic and
neurosurgical methods can be used to ablate pain pathways or implant devices
for drug delivery or electrical stimulation of neural structures. For any
invasive therapy, the risks, availability of expertise and suitable support
systems, and cost should be considered in addition to the apparent necessity or
medical indication.
Abdominal Pain
NONPHARMACOLOGIC INTERVENTIONS: INVASIVE THERAPIES
Brachytherapy
Nerve Blocks
Neurosurgery
Peripheral Neurectomy
Neuroaugmentation
Surgical Management of Pain due to Primary or Metastatic Tumor
Index