Neurolysis of the sympathetic axis for cancer pain management

Neurolytic blocks of sympathetic axis was a procedure that was widely used in the past for the control of upper abdominal pain or pelvic pain in patients with cancer. However, new studies suggest that these blocks are not effective in treating pain that is not visceral in origin. Consequently, when there is evidence of disease outside of the viscera, such as patients with lymphadenopathy, the success rate decreases significantly. Moreover, a controlled randomized study has shown that, even in the best-case scenario, the length of full pain control is no more than 2 months. Thus, we should re-consider our indications for these procedures, and when indicated, they should be performed early in the course of the disease.