New radiation treatment for pancreatic cancer pain now in US guidelines

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Experts at Sheba Medical Center in Israel have developed a new radiation treatment that significantly reduces the severe pain caused by pancreatic cancer by targeting the celiac plexus nerve, offering patients less suffering while undergoing life-saving treatments, and has now been included in the new American guidelines for treating this aggressive disease.

Pancreatic cancer, which also causes patients to endure severe pain, is one of the deadliest malignant diseases, leading to high mortality rates within months of often too-late diagnosis. Experts at Sheba Medical Center have developed a new method to ease the pain patients experience during aggressive treatments aimed at saving their lives. The development was published in the latest issue of The Lancet medical journal.

Severe pain is a characteristic of pancreatic cancer because the pancreas is very close to a central nerve called the celiac plexus. Pancreatic tumors tend to press on or infiltrate this nerve, causing very intense pain. This pain causes significant suffering to patients, affecting their daily routines and quality of life.

Until now, standard treatments for this pain included pain medications or, in severe cases where the pain was resistant to drugs, invasive treatment – injecting anesthetic substances directly into the celiac plexus nerve and disabling it (Celiac Block).

The new research, which began in recent years, is led by the head of the Radiation Institute at Sheba Medical Center, Dr. Jacob Lawrence, and is in collaboration with the Israel Cancer Association and other researchers. The study examined a treatment method of a single radiation session using high-dose X-rays directly to the nerve involved in severe pain.

The entrance to the Center for the Rehabilitation of War Casualties, Sheba Medical Center, Tel Hashomer, Israel. (credit: Aaron Poris/The Media Line)

The international study, conducted in the US, Canada, Poland, Portugal, and Israel, involved 125 patients who received a single high-dose radiation treatment to the celiac plexus nerve. Fifty-three percent of them reported a significant reduction in pain as a result of the treatment and a notable improvement in their quality of life.

Reported side effects were mainly mild, and included fatigue and some nausea on the day of treatment.

Pain is only one of the factors

The study’s findings have already achieved an important milestone: the treatment method has been included in the new American guidelines for treating pancreatic cancer and is now available to most patients in the US. Patients can now also receive innovative treatment at Sheba Medical Center.

“Pain is one of the factors causing the most suffering to pancreatic cancer patients,” notes Dr. Lawrence. “These are intense pains that affect the daily functioning and quality of life of the patients. In cases where the pain intensifies, patients require high doses of morphine-family drugs, which have severe side effects. The new radiation treatment is relatively simple and may significantly ease the patients’ immense suffering.”

The celiac plexus is a complex network of nerves located in the abdomen near the pancreas. When pancreatic tumors press on or infiltrate this nerve, it results in severe pain. The traditional method of pain relief has been to block this nerve using an anesthetic injection, a procedure known as a celiac block.

The new method developed by Sheba Medical Center uses a single high-dose radiation session to achieve similar pain relief, offering a less invasive option with mild side effects. This advancement is now part of the American guidelines for treating pancreatic cancer, making it accessible to many US patients.

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