The Neuromodulation Center for Cancer Pain at Memorial Sloan Kettering brings together highly skilled experts in anesthesiology, neurosurgery, and rehabilitation medicine to care for patients with cancer-related pain. Our doctors help to relieve symptoms and decrease discomfort through the use of neuromodulation, which involves stimulating or giving medications directly to the body’s nervous system.
We are the only center in the tristate region dedicated exclusively to alleviating pain caused by cancer and its treatments. Our doctors care for more than 1,600 patients with cancer pain each year and have developed a great deal of expertise.
Who We Are
We offer a complete array of treatment approaches, including:
- Intrathecal drug delivery
This technique supplies pain medication directly to the spinal cord. A pump is surgically placed under the abdominal skin and delivers pain medication through a catheter to the area around the spinal cord.
- Spinal cord stimulation
In this method, a mild electric current blocks nerve impulses in the spine. Thin wires are placed near the spinal cord, and a small device called a spinal cord stimulator sends electrical signals through the wires to regulate the spinal cord so the brain feels less pain.
- Peripheral nerve stimulation
This method involves surgery that places small electrodes next to peripheral nerves, which are located outside the brain and spinal cord. The electrodes are turned on and convey an electrical current to the nerves. This type of stimulation can greatly reduce pain signals going to the brain.
A cordotomy disables nerves in the spinal cord that are responsible for conducting pain impulses to the brain. This especially helps patients with severe pain coming from one arm, one leg, or one side of the chest wall.
- Spine surgery
Surgery may provide stability to the spinal column and reduce pressure on nerves, which will relieve pain.
Neuroablation uses state-of-the-art radiofrequency or focused ultrasound (both forms of heat therapy) or cryotherapy (cold therapy) to reduce pain resulting from the small sensory nerves in the body. This may be especially helpful for treating joint pain, chest wall pain, and pain after surgery.
- TENS therapy
Transcutaneous electrical nerve stimulation (TENS) is a therapy that uses low-voltage electrical current for pain relief. A small, battery-powered machine with wires connected to it conducts electrical current to the skin at the area of pain. This creates a circuit of electrical impulses that travels along nerve fibers to alleviate pain.
Because each person responds differently to pain and its treatments, we tailor our care to each patient to be as effective as possible. Our doctors work with referring physicians as well as physiatrists or physical therapists to ensure a smooth recovery.
Patients who have a great deal of pain often have to stop cancer treatment until it is brought under control. By reducing or eliminating pain, we allow patients to resume treatment by their oncologist as soon as possible, whether the physician is an MSK doctor or — as is more often the case — an oncologist in the community. Our doctors also are experts in helping patients manage pain during cancer care without interfering with cancer treatment when possible.
Specialized Treatment of Cancer-Specific Pain
Our doctors are practiced in treating:
We work with both MSK and community oncologists and radiation experts to combine pain treatment options with neuromodulation techniques so patients can continue receiving therapy in as much comfort as possible. This may include nerve blocks to temporarily relieve pain. In this procedure, a physician injects a local anesthetic into or around nerves or below the skin in the area where there is pain. The anesthetic interrupts transmission of pain signals to the brain and may provide relief for up to several hours.
We are highly specialized in treating post-mastectomy pain (caused by surgery to treat breast cancer), post-thoracotomy pain (resulting from surgeries to treat lung cancer or other cancers in the upper chest), and post-laminectomy pain syndrome (also called failed back syndrome), which can occur after surgery intended to relieve compression of spinal nerves due to cancer.
Sometimes chemotherapy can cause pain to the nerves outside the brain and spinal cord. We are investigating new ways to treat chemotherapy-induced peripheral neuropathy (CIPN) through neuromodulation including TENS therapy, peripheral and spinal cord stimulation, and IV infusion therapy (including lidocaine therapy). These methods can reduce the pain that a patient feels on a daily basis.
Radiation treatment can cause neuritis (inflammation of nerves) and myositis (inflammation of muscle tissue). It also can cause bones to fracture, which can happen years after treatment has ended. All of these conditions can cause pain that requires specialized treatment.