Coeliac plexus block for pancreatic cancer pain

Pancreatic Cancer UK says the cancer can press on a bundle of nerves called the coeliac plexus near the pancreas, causing pain in the tummy or back, and that painkillers or a nerve block may help. NICE NG85 (1.5.1) says consider EUS-guided or image-guided percutaneous neurolytic coeliac plexus block for people with uncontrolled pancreatic pain, unacceptable opioid adverse effects or escalating doses of analgesics, and (1.5.2) do not offer thoracic splanchnicectomy. Macmillan describes the procedure: you may be sedated, you lie on your front and the doctor injects local anaesthetic and a steroid (or a nerve-destroying agent) into the nerves through your back under X-ray or ultrasound guidance, or the injection is given from inside the body during an endoscopic ultrasound; the back may be sore for a few hours or days. In a randomised double-blind trial (Wyse 2011) of 96 people with inoperable pancreatic cancer, early EUS-guided coeliac plexus neurolysis at the time of the diagnostic endoscopy reduced pain at three months compared with pain medicines alone, with a trend to lower opioid use. Cancer Research UK says the block stops the signals that cause pain in the upper abdomen and is one option among painkillers, nerve-pain drugs (amitriptyline, gabapentin), palliative radiotherapy and cancer treatment itself. This is orientation from public patient pages and guidelines, not advice for your case: your own team's instructions and 24-hour number come first.