Cancer Pain Management in Chennai — Advanced Relief. Compassionate Care.

Cancer pain is not like other pain.

It does not always respond to standard painkillers the way musculoskeletal pain does. It can come from multiple sources simultaneously — the tumour pressing on nerves or organs, the effects of chemotherapy and radiation on nerve tissue, bone involvement, inflammation, or a combination of all of these together.

It can be constant. It can be severe. It can disrupt sleep, appetite, and the ability to be present with the people you love.

And yet — in many hospitals and oncology clinics across India — cancer pain is still significantly undertreated. Patients are told it is a normal part of the disease. Families are told nothing more can be done.

That is not always true.

Advanced interventional pain medicine has changed what is possible for cancer pain patients. Targeted procedures — nerve blocks, radiofrequency ablation, neurolytic techniques, intrathecal therapy — can provide relief that medication alone cannot. And they can be integrated alongside your existing oncology treatment without interruption.

Understanding the source of pain is the first step toward treating it effectively. Cancer pain typically arises from one or more of the following:

Tumour-Related Pain Direct pressure or invasion of the tumour on surrounding nerves, organs, soft tissue, or bone. This is often the most severe and persistent type of cancer pain — and the type that responds best to targeted interventional procedures.:

Bone Metastasis Pain When cancer spreads to bone, it causes deep, aching pain that is often worse at night and with movement. This type of pain can significantly limit mobility and independence. Radiofrequency Ablation and targeted nerve blocks are particularly effective for bone metastasis pain.:

Neuropathic Pain from Treatment Chemotherapy-induced peripheral neuropathy (CIPN) causes burning, tingling, numbness, and shooting pain in the hands and feet. Radiation therapy can also cause nerve damage in the treated area. These types of pain require specific neuropathic treatment approaches — different from standard cancer pain management.:

Post-Surgical Pain Pain that persists at the surgical site long after the procedure. Common after breast cancer surgery, thoracic surgery, or abdominal cancer operations. Often described as burning or hypersensitive skin — and often undertreated because it is attributed to the surgery rather than recognised as a distinct pain syndrome.:

A nerve block is a precise, image-guided procedure that interrupts the pain signals travelling from the source of pain to the brain.

Rather than covering pain with medication throughout the entire body, a nerve block targets the exact nerve pathway responsible for the pain — delivering relief directly at its origin.

Rapid reduction in pain intensity — often within hours of the procedure

Significant reduction in oral opioid requirement — reducing side effects such as constipation, drowsiness, and nausea

Improved sleep, appetite, and daily function

Relief that persists far longer than medication alone

Coeliac Plexus Block — for upper abdominal cancer pain (pancreatic, gastric, hepatic cancers)

Superior Hypogastric Plexus Block — for pelvic cancer pain (cervical, ovarian, bladder, rectal cancers)

Intercostal Nerve Block — for chest wall pain from lung or pleural involvement

Paravertebral Block — for unilateral chest, abdominal, or back pain

Radiofrequency Ablation uses carefully controlled thermal energy to modify the pain-transmitting nerves responsible for cancer-related pain.

Bone metastasis pain — where RFA can treat the tumour directly in the bone while simultaneously interrupting local pain signals

Facet joint or spinal pain secondary to vertebral involvement

Persistent pain in a specific nerve distribution that has not responded to blocks

Duration of relief: Typically 6–18 months, significantly longer than injection-based treatments.

Coeliac Plexus Neurolysis — for intractable upper abdominal and pancreatic cancer pain. A chemical agent is used to permanently disrupt the coeliac nerve plexus. Studies consistently show 70–90% of patients achieve meaningful and sustained pain reduction after this procedure.

Superior Hypogastric Plexus Neurolysis — for severe pelvic cancer pain. Provides lasting relief for patients with gynaecological, colorectal, or bladder cancers causing persistent pelvic pain.

These procedures are offered only after careful patient selection, with the goal of improving comfort and dignity in the final stages of disease.

For patients with widespread or complex cancer pain that requires continuous management, an Intrathecal Drug Delivery System — commonly called a pain pump — delivers medication directly into the spinal fluid.

This approach uses a fraction of the oral medication dose to achieve superior pain control — because the medication is delivered precisely where it acts, rather than circulating through the entire body.

Dramatically lower medication doses required — with proportionally fewer side effects

Continuous, consistent pain control around the clock

Particularly effective for patients who have developed tolerance to oral opioids

Improved alertness and cognitive clarity compared to high-dose oral medication

One of the most common misconceptions about palliative care is that it is only for patients who are near the end of life. This is not true — and this misconception causes real harm by delaying access to care that could significantly improve quality of life at any stage.

Palliative care is specialist care focused on relieving symptoms, reducing suffering, and improving the daily experience of life for patients with serious illness — and for their families.

It can be integrated from the moment of diagnosis. It works alongside curative treatment, not instead of it.

Pain and Symptom Control Systematic assessment and management of pain, breathlessness, fatigue, nausea, and other distressing symptoms — going beyond what standard oncology follow-up addresses.

Coordination with Your Oncology Team Dr. RRB works in close collaboration with your treating oncologist and oncology team. Every interventional pain decision is made in the context of your overall cancer treatment plan — ensuring nothing conflicts with your primary care.

Psychological and Emotional Support Serious illness affects not just the body but the mind and the family unit. Our palliative approach addresses anxiety, depression, existential distress, and the emotional burden that cancer places on patients and their caregivers.

Family Support and Caregiver Guidance Families carry an enormous burden. We provide guidance on managing pain at home, what to expect at different stages, and how to provide comfort — because when a patient is at home, the family is the care team.

Nutritional and Functional Support Cancer and its treatment affect appetite, weight, and energy. We address these as part of the overall symptom burden — not as separate concerns.

Palliative care does not give up on life. It fights for the quality of the life that remains.

Dr. RajaRajan Balasubramanian holds the FIPP (Fellow of Interventional Pain Practice, USA) — the international gold standard certification for interventional pain specialists. He is one of fewer than five specialists in India to hold both FIPP and DABRM simultaneously.

This means procedures like coeliac plexus neurolysis, intrathecal therapy, and advanced nerve blocks are performed to the highest international standard — with imaging guidance for precision and safety.

Cancer pain rarely has a single source. Dr. RRB evaluates the full pain picture — tumour-related, treatment-related, neuropathic, and psychological — and builds a comprehensive management plan that addresses all dimensions, not just the most obvious one.

Every patient who comes to Dr. RRB Pain Care for cancer pain management continues their oncology treatment without interruption. We communicate directly with oncology teams to ensure complete coordination. Pain management and cancer treatment are partners — not alternatives.

We understand that cancer pain consultations are not ordinary appointments. Patients and families arrive carrying fear, grief, exhaustion, and hope. Every consultation at Dr. RRB Pain Care is conducted with the time, space, and compassion these conversations require.

There is no wrong time to ask for help with cancer pain. But these situations in particular warrant a specialist pain consultation:

Pain that is persistent, severe, or rated 6 or above on a 10-point scale despite regular medication

Pain that is disrupting sleep, appetite, or the ability to be present with family

Side effects from pain medication — drowsiness, confusion, severe constipation — that are reducing quality of life as much as the pain itself

Bone pain or nerve pain that standard medication is not adequately controlling

A desire to reduce opioid medication while maintaining or improving pain control

A diagnosis of advanced-stage cancer and the need for a comprehensive pain and palliative care plan

A patient who has been told "nothing more can be done" for their pain — and whose family wants a second opinion

If you are a caregiver reading this: Your instinct to seek help for your loved one is right. Please reach out. Even one consultation can change what is possible.

Cancer pain varies widely in intensity and character depending on the type of cancer, its stage, location, and the treatments being used. Some patients experience moderate, manageable pain throughout their illness. Others experience severe, complex pain that requires specialist intervention. What matters is not comparing pain levels to others — but ensuring that the pain you or your loved one is experiencing receives proper assessment and treatment. Undertreated cancer pain is a medical and quality-of-life problem that can be addressed.

Cancer pain management is a specific component of palliative care — focused on reducing pain through both medication optimisation and interventional procedures. Palliative care is broader — it encompasses pain control, management of other symptoms (nausea, fatigue, breathlessness), psychological support, family guidance, and coordination of care. At Dr. RRB Pain Care, both are integrated into a single comprehensive approach tailored to each patient.

The coeliac plexus is a network of nerves in the upper abdomen responsible for transmitting pain signals from the pancreas, liver, stomach, and surrounding organs. A coeliac plexus block — or neurolysis for advanced cases — interrupts these pain signals with a precise injection under imaging guidance. It is most commonly used for patients with pancreatic cancer, upper abdominal tumours, or gastric cancer causing severe abdominal pain. Studies show that 70–90% of patients achieve significant, lasting pain relief from this procedure.

An intrathecal drug delivery system — or pain pump — delivers pain medication directly into the cerebrospinal fluid surrounding the spinal cord. Because the medication reaches its target directly rather than circulating through the entire body, a tiny fraction of the oral dose achieves far superior pain control. It is typically recommended for patients with widespread or severe cancer pain who have not achieved adequate relief from oral medication, or who are experiencing significant side effects from high oral opioid doses. The device is implanted in a minor surgical procedure and can be adjusted non-invasively over time.

Cancer is hard enough. The pain does not have to be.

Whether you are a patient looking for relief or a family member trying to help someone you love — we are here. One conversation with Dr. RRB can open options you may not have known existed.

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Consultations conducted with complete sensitivity and confidentiality.